Acute aorta, overview of acute CT findings and endovascular treatment options

Černá, Marie; Köcher, Martin; Thomas, Rohit Philip

doi:10.5507/bp.2016.060

“…The branch vessel was supplied by the true cavity and the false lumen. Chest or pericardial exudate CT value > 20HU was defined as chest or pericardial hemorrhage [28].…”

Section: Mdct Scanning Methods and Ct Image Analysismentioning

confidence: 99%

Branches of the brachiocephalic was an independent risk factor for hemorrhagic pulmonary sheath (HPS) patients with acute Stanford A aortic dissection

Xie¹,

Qin²,

Lin

³

et al. 2020

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0

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Background: AAD refers to the blood flow into the middle membrane through the intimal rupture of the aorta. Hemorrhagic pulmonary sheath (HPS) is a common complication of Stanford-A AAD. The risk factors of HPS are remaining unclear Methods: In this study, we have probed the potential risk factors of HPS patients with acute Stanford A aortic dissection. 18 HPS patients with acute Stanford A aortic dissection were selected as the case group. The age difference ± 5 years and the same sex are set as the matching principles. 36 patients with acute Stanford-A type AD who did not detect HPS in the same period were matched according to the ratio of 1:2. Demographic data, treatment methods, AD-related disease history, clinical symptoms and Charlson comorbidity index (CCI) values of each patient were collected. Meanwhile, the values of the maximum diameter of ascending aorta (mm), aortic dissection range, and the main branch of the aorta, pleural effusion/blood, and pericardial effusion/blood were measured by two experienced cardiovascular radiological physicians. Univariate and multivariate conditional logistic regression analysis was used in this study. Results: CCI value and the branches of the brachiocephalic in the case group were significantly higher than those in the control group (p<0.05). Univariate conditional logistic regression analysis showed CCI and branches of the brachiocephalic were associated with HPS. Multivariate conditional logistic regression analysis suggested that branches of the brachiocephalic were an independent risk factor for HPS (OR=7.02, 95%CI=1.28-38.62, p=0.025). Conclusions: Branches of the brachiocephalic were an independent risk factor for HPS.

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“…Any combination of dissection involving the celiac trunk or superior mesenteric artery or left or right renal artery or celiac trunk, superior mesenteric artery, left renal artery, and the right renal artery was de ned as abdominal branch vessel involvement. Chest or pericardial exudate CT value > 20HU was de ned as chest or pericardial hemorrhage [28].…”

Section: Mdct Scanning Methods and Ct Image Analysismentioning

confidence: 99%

Branches of the brachiocephalic was an independent risk factor for hemorrhagic pulmonary sheath (HPS) patients with acute Stanford A aortic dissection

Xie¹,

Qin²,

Li

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background: AAD refers to the blood flow into the middle membrane through the intimal rupture of the aorta. Hemorrhagic pulmonary sheath (HPS) is a common complication of Stanford-A AAD. The risk factors of HPS are remaining unclear Methods: In this study, we have probed the potential risk factors of HPS patients with acute Stanford A aortic dissection. 18 HPS patients with acute Stanford A aortic dissection were selected as the case group. The age difference ± 5 years and the same sex are set as the matching principles. 36 patients with acute Stanford-A type AD who did not detect HPS in the same period were matched according to the ratio of 1:2. Demographic data, treatment methods, AD-related disease history, clinical symptoms and Charlson comorbidity index (CCI) values of each patient were collected. Meanwhile, the values of the maximum diameter of ascending aorta (mm), aortic dissection range, and the main branch of the aorta, pleural effusion/blood, and pericardial effusion/blood were measured by two experienced cardiovascular radiological physicians. Univariate and multivariate conditional logistic regression analysis was used in this study. Results: CCI value and the branches of the brachiocephalic in the case group were significantly higher than those in the control group (p<0.05). Univariate conditional logistic regression analysis showed CCI and branches of the brachiocephalic were associated with HPS. Multivariate conditional logistic regression analysis suggested that branches of the brachiocephalic were an independent risk factor for HPS (OR=7.02, 95%CI=1.28-38.62, p=0.025). Conclusions: Branches of the brachiocephalic were an independent risk factor for HPS.

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“…Computed tomography angiography (CTA) is a rapid imaging technique that is less invasive than conventional aortography and is the most widely chosen diagnostic method for patients with possible acute aortic pathology. However, CTA still requires the use of contrast media and radiation (5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Aortic dissection assessment by 4D phase-contrast MRI with hemodynamic parameters: the impact of stent type

Chen¹,

Tseng²,

Lin³

et al. 2021

Quant Imaging Med Surg

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Background: To explore the diagnostic performance of 4-dimensional phase-contrast magnetic resonance imaging (4D PC-MRI) in evaluating aortic dissection in different clinical scenarios. Methods:The study group comprised 32 patients with a known aortic dissection who each underwent computed tomography angiography (CTA), and then 4D PC-MRI with a 1.5-T MR scanner. The 4D PC-MRI images were compared with the CTA images to evaluate the aortic size, branch identification, and iliac and femoral arterial access.Results: The patients were divided into three groups: (I) patients diagnosed with Type B aortic dissection but did not undergo intervention (n=8); (II) patients with residual aortic dissection after open repair of Type A dissection (n=7); (III) patients who underwent endovascular aortic repair with or without open surgery (n=17). Without radiation or contrast media injection, 4D PC-MRI provided similar aortic images for patients in Group 1 and most of those in Group 2. In Group 3, stainless steel stents affected image quality in three patients. High-quality 4D PC-MRI images were obtained for the remaining 14 patients in Group 3, who had non-stainless steel stents, and provided major aortic information comparable to that provided by CTA with contrast media. The hemodynamic parameters of true and false lumens were evaluated between three patients with Type B aortic dissections and three patients who underwent thoracic endovascular aortic repair for their aortic dissection. The stroke volume was higher in the true lumen of the patients with stentgrafts than in the patients with Type B aortic dissection without intervention. The regurgitant fraction, an indicator of nonlaminar flow, was higher in the false lumens than in the true lumens. All 32 patients in this study tolerated 4D PC-MRI without adverse events.Conclusions: 4D PC-MRI is radiation-and contrast media-free option for imaging aortic dissection. It not only provided images comparable in quality to those obtained with CTA but also provided information on hemodynamic parameters, including endoleak detection after thoracic endovascular aortic repair. 4D PC-MRI was safe and accurate in evaluating chronic Type B aortic dissection and residual aortic dissection after surgery for acute Type A aortic dissection. Therefore, it could be a potential tool in treating pathology in aortic dissection, especially for patients with malperfusion syndrome of visceral vessels and in young patients with renal function impairment. However, certain endograft materials, especially stainless steel, may prevent the further application of 4D PC-MRI and should be avoided.

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Acute aorta, overview of acute CT findings and endovascular treatment options

Cited by 10 publications

References 76 publications

Branches of the brachiocephalic was an independent risk factor for hemorrhagic pulmonary sheath (HPS) patients with acute Stanford A aortic dissection

Branches of the brachiocephalic was an independent risk factor for hemorrhagic pulmonary sheath (HPS) patients with acute Stanford A aortic dissection

Branches of the brachiocephalic was an independent risk factor for hemorrhagic pulmonary sheath (HPS) patients with acute Stanford A aortic dissection

Aortic dissection assessment by 4D phase-contrast MRI with hemodynamic parameters: the impact of stent type

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