Hazard of Retrograde Aortography in Dissecting Aneurysm

Hart, William Le Roy; Berman, Edward J.; Lacom, Richard J.

doi:10.1161/01.cir.27.6.1140

Cited by 30 publications

(8 citation statements)

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“…Further, there is also the risk that advancing the catheter or guidewire may cause extension of the dissection, displacement of thrombotic material, or outright perforation of the aorta 9. Previous authors have suggested that such technical issues can be circumvented by first evaluating the patient's pulses, reviewing other diagnostic imaging, and using larger sheaths and guidewires to allow better visualization and torque control 10 11.…”

Section: Discussionmentioning

confidence: 99%

Endovascular thrombectomy in the setting of aortic dissection

Reznik

Espinosa-Morales

Jumaa

et al. 2016

J NeuroIntervent Surg

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These three cases suggest that endovascular thrombectomy is feasible and can be done safely and efficaciously in patients with aortic dissections and those with Marfan syndrome, although the risks and benefits should be considered as part of any decision-making process. Given that endovascular therapy for acute stroke is now in many situations part of standard care, further studies will be necessary to delineate more precise inclusion and exclusion criteria.

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Section: Discussionmentioning

confidence: 99%

Endovascular thrombectomy in the setting of aortic dissection

Reznik

Espinosa-Morales

Jumaa

et al. 2016

J NeuroIntervent Surg

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“…Conventional coronary angiography, which is the gold standard for coronary artery visualization, is associated with certain risks. Advancement of a diagnostic catheter into the false lumen may potentially extend dissection [11]. In case of present coronary artery dissection, conventional coronary angiography may not be possible from the true lumen.…”

Section: Discussionmentioning

confidence: 99%

Computed tomographic coronary angiography in patients with surgically treated type A aortic dissection: preliminary results

et al. 2009

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Acute type A aortic dissection is a serious emergency with a mortality rate of up to 40% within the first 24 h when left untreated. Surgical therapy needs to be initiated promptly. Due to this urgent situation, preoperative evaluation of the coronary arteries is not routinely performed in these patients. The aim of this study was to evaluate the accuracy of 64-slice computed tomography angiography (CTA) for postoperative coronary artery assessment in these patients. Ten consecutive patients with two or more cardiovascular risk factors were prospectively enrolled. Patients had type A aortic dissection treated surgically with a supracoronary graft of the ascending aorta. Performance of CTA to exclude significant stenosis (>50% lumen narrowing) and/or coronary artery dissection was compared with quantitative coronary angiography. A total of 147 segments were evaluated. Three segments (2%) were excluded from analysis. CTA correctly assessed one of three significant stenoses in three patients and correctly excluded coronary artery disease (CAD) in six of ten patients. One patient was rated false positive. Overall accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CT for identifying coronary artery disease by segment was 98%, 33%, 99%, 50%, and 99%, respectively (P<0.05). By patient, it was 70%, 33%, 86%, 50%, and 75%, respectively. No coronary artery dissection was found. Noninvasive CTA may be a viable alternative to conventional angiography for postoperative coronary artery evaluation in patients with surgically treated type A aortic dissection and cardiovascular risk factors. An NPV of 99% should allow for reliable exclusion of CAD. Further studies with higher patient numbers are warranted.

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“…Transeptal catheterization of the left atrium has been claimed to avoid the hazards of arterial catheter techniques (Hart et al, 1963 ; Allen and Trapp, 1966), but may be dangerous rlustralasian Radiology, Vol. X V , No.…”

Section: Disclssionmentioning

confidence: 99%

“…Yet another method has been the injection of contrast on the left side of the heart, either through an atrial transseptal catheter (Hart et al, 1963 ;Allen and Trapp, 1966) or a t left ventricular puncture (Heslep and Greening,196i).…”

Section: Introductionmentioning

confidence: 99%

Transfemoral Catheter Aortography in Dissecting Aneurysm

Syme

1971

Australas Radiol

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Summary The several methods available for aortography in dissecting aneurysm are reviewed critically with reference to the diagnostic information provided and to patient safety. The trans‐femoral catheter technique found satisfactory on both of these counts in a majority of 18 personal cases is described in detail. Particular emphasis is laid on why the abdominal portion of the aorta should usually be examined as well as the thoracic and on why accidental catheterization and injection of the dissection sac need not be hazardous in experienced hands. An explanation is given for the occasional necessity in the series to catheterize the aorta from an upper limb artery and a preference is expressed for the left transaxillary route as an alternative to the transfemoral in such circumstances.

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Hazard of Retrograde Aortography in Dissecting Aneurysm

Cited by 30 publications

References 1 publication

Endovascular thrombectomy in the setting of aortic dissection

Endovascular thrombectomy in the setting of aortic dissection

Computed tomographic coronary angiography in patients with surgically treated type A aortic dissection: preliminary results

Transfemoral Catheter Aortography in Dissecting Aneurysm

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