Introduction
Although the current treatment strategy (wait-and-watch strategy) for type B intramural hematoma (IMHB) is in line with the management of type B dissections, the long-term outcomes of IMHBs are not as good as those of type B dissections [1-4] . Schoenhoff et al.[5] reported that 43% of IMHB patients underwent thoracic endovascular aortic repair (TEVAR) during the first two weeks because of the visualization of an entry tear and development of an aneurysm, and 19% of patients received TEVAR after the acute phase and during the first-year. Durham and colleagues also reported that the survival rates of type B intramural hematoma patients who underwent interventional treatment was only 76% and only 40% of patients did not require reintervention [6] . The cause of this phenomenon is that the evolution of IMHBs is highly unpredictable and can vary from complete resolution to abrupt rupture.
The prevalence of diabetes mellitus (DM) in patients requiring cardiac surgery is significantly increasing and achieving tight perioperative glycemic control in DM patients could decrease perioperative morbidity and improve survival [7] . Regarding aortic diseases, current studies have demonstrated a negative correlation between DM and the occurrence of aortic diseases [8-11] . However, previous studies are contradictory in that patients with DM were found to have poorer outcomes after abdominal aortic aneurysm repair[12], whereas mortality and clinical complications in type B aortic dissection patients after TEVAR were significantly reduced in DM patients [13] . In our previous study, we had demonstrated that uncomplicated type A IMH patients with DM (receiving the “wait‐and‐watch strategy” and tight glycemic control) may have lower aorta‐related mortality and rates of aorta‐related adverse events and reinterventions than the non-DM group [14] And whether patients with uncomplicated IMHB (receiving the “wait‐and‐watch strategy”) may benefit from the tight glycemic control remains unclear.
In sum, we hypothesized that in uncomplicated IMHB patients who received the “wait-and-watch strategy” (combined with tight glucose management), patients with DM (compared with patients without DM) would benefit from such a treatment strategy. In this study, we aimed to summarize the clinical presentation, therapeutic approaches, and outcomes of IMHB patients with and without DM.