Diagnostic Utility of Unenhanced Computed Tomography for Acute Aortic Syndrome

Kurabayashi, Manabu; Okishige, Kaoru; Ueshima, Daisuke; Yoshimura, K.; Shimura, Tsukasa; Suzuki, Hiroyoshi; Asano, Michio; Aoyagi, Haruhiko; Otani, Yoichi; Isobe, Mitsuaki

doi:10.1253/circj.cj-14-0198

Cited by 31 publications

(29 citation statements)

References 19 publications

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“…19 CT is also useful for diagnosing aortic complications. 20, 21 In the wrapping group, 44 patients had CT aortic root dilatation. During the study period, the preoperative ascending aortic diameter in the AVR group was less than 45 mm (40.9±4.2 (median 40.6) mm, Table 1).…”

Section: Follow-upmentioning

confidence: 99%

Aortic Wrapping for a Dilated Ascending Aorta in Bicuspid Aortic Stenosis

Choi

Jeong

Lee

et al. 2015

Circ J

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Section: Follow-upmentioning

confidence: 99%

Aortic Wrapping for a Dilated Ascending Aorta in Bicuspid Aortic Stenosis

Choi

Jeong

Lee

et al. 2015

Circ J

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“…CT is a useful modality for diagnosing A-AAD, 21 and the that younger age and brachiocephalic branch re-entry were significant risk factors. Only the existence of brachiocephalic branch re-entry remained as a significant risk factor in the multivariate analysis (HR: 4.01, 95% CI: 1.02-15.81, P=0.047, Table 3).…”

Section: Long-term Follow Upmentioning

confidence: 98%

Evaluation and Influence of Brachiocephalic Branch Re-entry in Patients With Type A Acute Aortic Dissection

Yasuda

Imoto

Uchida

et al. 2017

Circ J

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aortic replacement in patients with A-AAD.A patent false lumen in the aortic arch is a well-known risk of late enlargement of the aortic arch. 1 We therefore evaluated brachiocephalic branch re-entry associated with type A-AAD and examined the early and long-term effect of brachiocephalic branch re-entry on the aortic arch after ascending aortic replacement. Methods Study GroupWe retrospectively studied 85 patients (49 men and 36 women; mean age, 62±12 years) who underwent ascending aortic replacement for A-AAD during the 9-year period from 2006 through to 2014, in whom multiple-detector computed tomography (MDCT) was performed preoperatively and postoperatively during hospitalization. Patients with an intramural hematoma or those 56 patients undergoing total arch replacement due to primary entry in the aortic arch were excluded. We also excluded 3 patients with primary entry at the proximal descending aorta who T ype A acute aortic dissection (A-AAD) remains to be a severe and complex disease because of its complications such as aortic rupture, aortic valve regurgitation, or malperfusion of vital organs. Although aortic dissection sometimes extends to brachiocephalic branches in patients with DeBakey type I aortic dissection, it is unclear how to treat these patients surgically. For instance, ascending aortic replacement, rather than total arch replacement, is performed in many cases with brachiocephalic branch dissection when initial entry is located at the ascending aorta. However, the effect of the presence of brachiocephalic branch dissection on the postoperative prognosis of A-AAD is greatly unknown.The ascending aortic replacement in patients with a dissected branch in the brachiocephalic region often resulted in the remaining patent false lumen in the aortic arch postoperatively, despite the absence of anastomotic leakage. We assumed that the presence of re-entry in the distal portion of the brachiocephalic branches make a false lumen in the brachiocephalic branches patent, which then may cause a false lumen of the aortic arch patent after the ascending Background: Stanford type A acute aortic dissection (A-AAD) extends to the brachiocephalic branches in some patients. After ascending aortic replacement, a remaining re-entry tear in the distal brachiocephalic branches may act as an entry and result in a patent false lumen in the aortic arch. However, the effect of brachiocephalic branch re-entry concomitant with A-AAD remains unknown.

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“…The identification of an intimal flap and a true and a false aortic lumen are definitive signs of aortic dissection, which allow CTA to diagnose AAD with high sensitivity and specificity [7,11,12]. CM injection rates and technical parameters may vary based on institutional preferences and patients' characteristics, different CT vendors and configuration of scanners.…”

Section: Triphasic Cta In Acute (Non-traumatic) Aortic Diseasementioning

confidence: 99%

“…If the contrast between the density of the aortic wall and the density of the aortic lumen is large, the intimal flap of AAD appears visible on unenhanced CT ( Fig. 1) [3,11]. In patients with adverse reaction to iodinated CM or with impaired renal function, these findings may be sufficient for diagnosis or for serial monitoring without administration of potentially nephrotoxic iodinated intravenous Table 1 There are several causes of endoleak which can be classified into five types as showed in this table, depending upon the origin of the leak.…”

Section: Triphasic Cta In Acute (Non-traumatic) Aortic Diseasementioning

confidence: 99%