| 1. Freeman LA, Young PM, Foley TA, Williamson EE, Bruce CJ, Greason KL. CT and MRI assessment of the aortic root and ascending aorta. AJR Am J Roentgenol 2013;200:W581-92. |
Review/Other-Dx |
N/A |
To provide an outline of aortic anatomy and disease patterns, describe methods of aortic measurement, and highlight measurement thresholds for surgical intervention. |
No results stated in abstract. |
4 |
| 2. Orr N, Minion D, Bobadilla JL. Thoracoabdominal aortic aneurysm repair: current endovascular perspectives. [Review]. Vasc Health Risk Manag. 10:493-505, 2014. |
Review/Other-Tx |
N/A |
To focus on the current state of endovascular thoracoabdominal aneurysm repair, including specific considerations in patient selection, operative planning, and perioperative complications. |
No Results Stated in Abstract. |
4 |
| 3. Elefteriades JA.. Natural history of thoracic aortic aneurysms: indications for surgery, and surgical versus nonsurgical risks. Ann Thorac Surg. 74(5):S1877-80; discussion S1892-8, 2002 Nov. |
Review/Other-Dx |
1600 patients with thoracic aneurysm and dissection |
To analyze patients with thoracic aortic aneurysms and dissections, and understand the natural behavior of the aorta and development of criteria for surgical intervention. |
Growth rate: the aneurysmal thoracic aorta grows at an average rate of 0.10 cm per year (0.07 for ascending and 0.19 for descending). Critical sizes: hinge points for natural complications of aortic aneurysm (rupture or dissection) were found at 6.0 cm for the ascending aorta and 7.0 cm for the descending. By the time a patient achieved these critical dimensions the likelihood of rupture or dissection was 31% for the ascending and 43% for the descending aorta. Yearly event rates: a patient with an aorta that has reached 6 cm maximal diameter faces the following yearly rates of devastating adverse events: rupture (3.6%), dissection (3.7%), death (10.8%), rupture, dissection, or death (14.1%). Surgical risks: risk of death from aortic surgery for thoracic aortic aneurysm was 2.5% for the ascending and arch and 8% for the descending and thoracoabdominal aorta. Genetic analysis: family pedigrees confirm that 21% of probands with thoracic aortic aneurysm have first-order family members with arterial aneurysm. |
4 |
| 4. Luo J, Fu X, Zhou Y, et al. Aortic Remodeling Following Sun's Procedure for Acute Type A Aortic Dissection. Medical Science Monitor. 23:2143-2150, 2017 May 05. |
Observational-Dx |
51 patients who underwent Sun's procedure for acute Stanford type A aortic dissection |
To analyze clinical outcomes and morphologic changes in true and false lumen by computed tomography (CT) angiography after Sun's procedure. |
Four patients died before surgical intervention and postoperative deaths occurred in five patients (in-hospital mortality rate 10.6%). Only 42 patients (36 male, 6 female; mean age, 45.9±9.8 years; range, 24-65 years) with acute type A aortic dissection were involved in our study. Thirty-five patients (83.3%) suffered from chest or abdominal pain and only one patient (2.4%) was asymptomatic. Thirty-seven patients (88.1%) had hypertension as the most common comorbidity. In the ascending aorta, false lumen was eliminated and the change of true lumen was not significant (p>0.05). In the descending aorta, complete and partial thrombosis of false lumen were observed in eight patients (19.0%) and 33 patients (78.6%) by one-month follow-up CT scan, respectively. After the six-month follow-up, the rate of complete thrombosis increased to 36.1% and partial thrombosis decreased to 61.9%. The area and maximal diameter of true lumen were increased significantly (p<0.05), whereas significant decreases were found in the area and maximal diameter of false lumen (p<0.05). In the abdominal aorta, thrombosis was found in 52.4% patients at one-month follow-up CT. Furthermore, there were no significant changes in both true and false lumen within three months (p>0.05). Nevertheless, the false luminal area and maximal diameter decreased significantly (p<0.05) after six months, while these changes of true lumen were not significant (p>0.05). |
2 |
| 5. Vardhanabhuti V, Nicol E, Morgan-Hughes G, et al. Recommendations for accurate CT diagnosis of suspected acute aortic syndrome (AAS)--on behalf of the British Society of Cardiovascular Imaging (BSCI)/British Society of Cardiovascular CT (BSCCT). British Journal of Radiology. 89(1061):20150705, 2016. |
Review/Other-Dx |
N/A |
To outline the best practice for the investigation of suspected AAS so that unequivocal diagnosis can be made based on imaging. |
No results in abstract. |
4 |
| 6. Zhao DL, Liu XD, Zhao CL, et al. Multislice spiral CT angiography for evaluation of acute aortic syndrome. Echocardiography. 34(10):1495-1499, 2017 Oct. |
Observational-Dx |
36 cases diagnosed as AAS by MSCTA |
To discuss the diagnostic value of multislice CT angiography (MSCTA) in acute aortic syndrome (AAS). |
Among 36 AAS cases, 16 cases had aortic dissection (AD), 8 cases had penetrating atherosclerotic ulcer (PAU), 7 cases had intramural hematoma (IMH), and 5 cases had unstable thoracic aneurysm (UTA). Of 16 cases with AD, type A and type B accounted for 43.7% (7/16) and 56.3% (9/16), respectively. Of 7 cases with IMH, type A and type B accounted for 42.9% (3/7) and 57.1% (4/7), respectively. |
4 |
| 7. Lombardi JV, Hughes GC, Appoo JJ, et al. Society for Vascular Surgery (SVS) and Society of Thoracic Surgeons (STS) reporting standards for type B aortic dissections. J Vasc Surg 2020;71:723-47. |
Review/Other-Dx |
N/A |
To illustrate and define the overall nomenclature associated with type B aortic dissection.To describe a new classification system for practical use and reporting that includes the aortic arch.To define chronicity of aortic dissection along with nomenclature in patients with prior aortic repair and other aortic pathologic processes, such as intramural hematoma and penetrating atherosclerotic ulcer.To provide a facile framework of language that will allow more granular discussions and reporting of aortic dissection in the future. |
No results in abstract. |
4 |
| 8. Hahtapornsawan S, Bisdas T, Torsello G, Criado FJ, Austermann M, Donas KP. Importance of Early Aortic Surveillance after Endovascular Treatment of Type B Aortic Dissection with Malperfusion Syndrome. Annals of Vascular Surgery. 36:106-111, 2016 Oct. |
Observational-Tx |
28 patients with TBAD and MPS |
To assess the incidence and timing of adverse events and complications occurring after endovascular treatment of type B aortic dissection (TBAD) complicated with malperfusion syndrome (MPS). |
The MPS included the mesenteric and renal arteries in 14 (50%) and 21 (75%) patients, respectively, the lower extremities in 14 (50%) patients and the spinal cord in 3 (10.7%). The 1-year and 5-year freedom of reintervention rate were 86.2% and 74.7%, respectively. The median time to reintervention was 4.5 months. The main reason for reintervention was type I proximal endoleak which was treated by proximal endograft extensions and appropriate arch-branch management. The perioperative mortality was 14.3% (4 of 28). The mean follow-up was 61.7 months (range, 2-96 months). The short-term and long-term survivals were 82.1% at 1 and 5 years, respectively. |
2 |
| 9. Lu W, Fu W, Wang L, et al. Morphologic characteristics and endovascular management of acute type B dissection patients with superior mesenteric artery involvement. Journal of Vascular Surgery. 74(2):528-536.e2, 2021 08. |
Observational-Tx |
212 consecutive patients with acute type B aortic dissection |
To study the associated risk factors and reported the outcomes of endovascular treatment. |
Computed tomography angiography confirmed 44 cases of SMAI: 12 (27.3%) with MMP and 32 (72.7%) without MMP. The patients with MMP had presented more frequently with lower extremity malperfusion (33.3% vs 3.1%; P = .023) than had those without MMP, with an odds ratio of 14.15 (P = .047). Multivariate analysis showed that patients with a low true lumen (TL)/false lumen (FL) diameter ratio of the SMA (TL/FL-SMA <1) had a greater risk of developing MMP than those with a high TL/FL-SMA ratio of >1 (odds ratio, 8.49; 95% confidence interval, 1.24-58.26; P = .029). SMA TL thrombosis was a significant predictor of the requirement for additional SMA revascularization after TEVAR among patients with MMP (P = .045). During a mean 10-month follow-up period, complete FL thrombosis in the SMA was seen in 11 patients (25%; 33.3% with MMP vs 21.9% without MMP; P = .43). The overall mortality rate was 6.82% (16.7% in the MMP group and 3.1% in the non-MMP group; P = .09). |
2 |
| 10. Midulla M, Fattori R, Beregi JP, Dake M, Rousseau H. Aortic dissection and malperfusion syndrome: a when, what and how-to guide. Radiol Med 2013;118:74-88. |
Review/Other-Dx |
N/A |
To present a when, what and how-to guide for all radiologists who encounter complicated aortic dissection. |
No results stated in abstract. |
4 |
| 11. Thakkar D, Dake MD. Management of Type B Aortic Dissections: Treatment of Acute Dissections and Acute Complications from Chronic Dissections. [Review]. Techniques in Vascular & Interventional Radiology. 21(3):124-130, 2018 Sep. |
Review/Other-Tx |
N/A |
To describe the decision-making treatment algorithm for management of type B aortic dissection. To provide a comprehensive review of the indications and procedural recommendations for performing TEVAR based on current evidence in the literature. To guide the readers through step-by-step practical considerations, from choosing the optimal graft to insuring its ideal deployment in type B dissection, as well as providing advice on how to handle a variety of procedure-related complications. |
No results in abstract. |
4 |
| 12. Ray HM, Durham CA, Ocazionez D, et al. Predictors of intervention and mortality in patients with uncomplicated acute type B aortic dissection. Journal of Vascular Surgery. 64(6):1560-1568, 2016 Dec. |
Observational-Dx |
294 patients with uATBAD |
To determine the predictors of intervention and mortality in patients with uncomplicated acute type B aortic dissection (uATBAD). |
During the study period, 294 patients with uATBAD were admitted with 156 having admission computed tomographic angiography imaging available for analysis. The cohort had an average age of 60.6 years (±13.6 years); 60% were males. The average follow-up time was 3.7 years (interquartile range, 2.1-6.9). A stratified analysis demonstrated the most sensitive cutoff for mortality was aortic diameter >44 mm (P < .01), and it appeared to be a threshold effect with minimal additional information added by finer size stratification. FL diameter did not predict mortality in our series (P = .36). Intervention-free survival, alternatively, appeared to decrease over the range of diameters from 35 to 44 mm (P < .01). An FL diameter >22 mm was associated with decreased intervention-free survival (P < .04). Age >60 years on admission also demonstrated decreased survival compared with those =60 years of age (P < .01). Diameter >44 mm persisted as a risk factor for mortality (hazard ratio, 8.6; P < .01) after adjustment for diabetes (6.7; P < .01), age (1.06/y; P < .01), history of stroke (5.4; P < .01), connective tissue disorder (2.3; P < .01), and syncope on admission (9.5; P < .04). The 1-, 5-, and 10-year intervention rate for patients with admission aortic diameter >44 mm was 18.8%, 29.5%, and 50.3%, respectively, compared with 4.8%, 13.3%, and 13.3% in the =44 mm group (P < .01). |
3 |
| 13. Lou X, Duwayri YM, Chen EP, et al. Predictors of Failure of Medical Management in Uncomplicated Type B Aortic Dissection. Annals of Thoracic Surgery. 107(2):493-498, 2019 02. |
Observational-Tx |
314 uTBAD patients undergoing OMT |
To identify predictors of aortic intervention and mortality in uncomplicated type B aortic dissection (uTBAD) patients undergoing optimal medical therapy (OMT). |
The mean age of patients was 58 ± 12 years, and 67% were men. FL status was patent in 59.4%, partially thrombosed in 39.8%, and completely thrombosed in 0.8% of patients. Over a median follow-up of 5.6 (interquartile range, 1.4 to 8.5) years, 44.9% of patients failed OMT and underwent intervention (n = 58 open, n = 83 endovascular). The estimated incidence of OMT failure was 46%. Multivariate analysis identified the presence of diabetes, renal failure, DeBakey 3B dissection, and a descending thoracic AD of 4.5 cm or greater (HR, 1.39; 95% confidence interval, 1.24 to 1.56; p < 0.001) to be independent predictors of failure of OMT. FL status or the distribution of visceral vessels arising from the FL did not predict OMT failure. |
2 |
| 14. Clough RE, Barilla D, Delsart P, et al. Editor's Choice - Long-term Survival and Risk Analysis in 136 Consecutive Patients With Type B Aortic Dissection Presenting to a Single Centre Over an 11 Year Period. European Journal of Vascular & Endovascular Surgery. 57(5):633-638, 2019 May. |
Observational-Dx |
136 patients with acute type B aortic dissection |
To evaluate, in patients with acute type B aortic dissection, the results of medical and endovascular treatment in a large single centre experience and to investigate the clinical and imaging features on presentation that relate to poor outcome. |
The mean follow up was 51 months (1-132), during which time 33 deaths and 48 aortic events occurred. At one and five years, overall survival was 94.0% and 74.8%, respectively, and freedom from aortic events was 75.6% and 58.7%. There was no difference in all cause survival and aortic event free survival at one and five years between the patients treated endovascularly and those receiving medical treatment alone. Risk analysis for aortic events demonstrated the maximum size of the proximal entry tear, the maximum thoracic aortic diameter, and the thoracic aortic false lumen maximum diameter to have a significant effect on the incidence of aortic events. |
2 |
| 15. Stelzmueller ME, Nolz R, Mahr S, et al. Thoracic endovascular repair for acute complicated type B aortic dissections. Journal of Vascular Surgery. 69(2):318-326, 2019 02. |
Observational-Tx |
55 patients with an acute complicated type B aortic dissection |
To retrospectively assess in-hospital mortality and long-term results of emergency thoracic endovascular aortic repair (TEVAR) for patients with life-threatening acute complicated type B aortic dissection (acTBD). |
Technical success (coverage of the primary intimal tear) was achieved in 50 patients (91%). The overall in-hospital mortality rate was 9% (n = 5), and there was a statistically significant difference in early mortality between group A and group B (7% vs 2%; P < .02). Causes of in-hospital death were all aorta related, including a rupture during the procedure and on the first postinterventional day in two patients and redissection (ascending aorta, n = 2; descending aorta, n = 1) with a consequent aortic rupture after TEVAR in the remaining three. Permanent neurologic dysfunction occurred in five patients (stroke, n = 2; paraplegia, n = 3). Overall, 19 patients (34%) developed early endoleaks (type IA, n = 5; type IB, n = 11; type II, n = 2; type IB plus type II, n = 1). Therefore, 5 patients needed early (within 30 days) endovascular intervention because of a type IA (n = 2), type IB (n = 3), or type II endoleak (n = 1) and the rapid progression of aortic diameter, persistent signs of ischemia (n = 2), or rupture (n = 1), whereas the remaining 14 patients were treated conservatively and followed up by computed tomography angiography. Seven patients with early endoleaks needed an endovascular intervention (n = 3) or conventional surgery (n = 4) because of aortic progression in the follow-up period (mean interval after procedure, 92 ± 56 months). The actual survival rates were 87%, 85%, and 75% at 1 year, 2 years, and 5 years, respectively, and freedom from aorta-related death was 87%, 87%, and 77% at 1 year, 2 years, and 5 years, respectively. Freedom from reintervention for any cause using a Kaplan-Meier analysis was 70%, 68%, 68%, and 63% at 6 months, 1 year, 2 years, and 5 years, respectively. |
2 |
| 16. Hosn MA, Goffredo P, Zavala J, et al. Analysis of Aortic Growth Rates in Uncomplicated Type B Dissection. Annals of Vascular Surgery. 48:133-140, 2018 Apr. |
Observational-Tx |
108 patients |
To analyze growth rate patterns of type B dissections based on computed tomography (CT) measurements over time. |
A total of 108 patients were included. Average age of patients was 58.7 years. Median follow-up time was 3 months for the first CT and 32 months for the second. OM was 27.8% (n = 30), whereas the disease-specific mortality was 11.1% (n = 12). Thirty-seven percent (n = 40) required operative intervention (18 open and 22 endovascular repair): 20 at 30 days, 12 at 12 months, and 8 patients at >1 year. Mean aortic growth rate was higher in the first time interval compared with the second: 0.89 vs. 0.19 mm/month (P < 0.05) at the proximal descending aorta, 1.01 vs. 0.18 mm/month (P < 0.05) at the mid-descending aorta, and 0.65 vs. 0.28 mm/month; (P < 0.05) at the distal descending aorta. Those who underwent intervention had a higher aortic growth rate at early and late interval (P < 0.05). Age and number of comorbidities were associated with OM. Thrombosis of the false lumen did not affect the mortality and intervention rate. |
2 |
| 17. Tolenaar JL, van Keulen JW, Trimarchi S, et al. Number of entry tears is associated with aortic growth in type B dissections. Ann Thorac Surg. 96(1):39-42, 2013 Jul. |
Observational-Dx |
60 patients |
To investigate whether the number of identifiable entry tears in acute type B aortic dissection (ABAD) patients is associated with aortic growth. |
Included were 60 patients who presented with 243 dissected segments. Mean growth rates during follow-up (median, 23.2; range, 3 to 132 months) were significantly higher in patients with 1 entry tear (5.6 +/- 8.9 mm) than in those with 2 (2.1 +/- 1.7 mm; p = 0.001) and 3 entry tears (mean 2.2 +/- 4.1; p = 0.010). The distance of the primary entry tear from the left subclavian artery did not have an effect on the aortic growth rate (median, 38; interquartile range, 24 to 137 mm; p = 0.434). |
4 |
| 18. Arafat A, Roselli EE, Idrees JJ, et al. Stent Grafting Acute Aortic Dissection: Comparison of DeBakey Extent IIIA Versus IIIB. Annals of Thoracic Surgery. 102(5):1473-1481, 2016 Nov. |
Observational-Dx |
108 patients with acute DeBakey type III dissection and underwent urgent/emergency TEVAR (41 patients with type IIIA and 67 patients with type IIIB) |
To compare characteristics, outcomes, and aortic remodeling after TEVAR between patients with DeBakey extent IIIA and IIIB dissection. |
Patients with IIIA dissection were older (69.9 ± 10 vs 59.5 ± 13 years; p < 0.001) and more likely to have had prior cardiovascular operations (p = 0.01) than IIIB. The most common indication for TEVAR was ischemia in IIIB (66%), and pain (34%) in IIIA. Rupture was more common in IIIA (24.3% vs 1.5%; p < 0.001). Aortic diameters were similar between groups, but IIIB patients had smaller true/false lumen ratio (0.89 ± 1.08 vs 1.76 ± 1.27; p = 0.003). Stent graft coverage was 152 ± 42 mm for IIIA vs 212 ± 85 mm for IIIB (p < 0.001). Additional branch stents were used in 20 IIIB patients (30%), and 7 had infrarenal stenting. Early mortality and complications were similar between groups, except for renal failure (4.4% IIIB vs 0% IIIA; p = 0.04). Mean follow-up was 30 ± 28 months. Estimated survival at 1, 3 and 5 years was 84%, 65%, and 38% for IIIA, and 70%, 66%, and 59% for IIIB, respectively, with no significant difference. Significant expansion of the true lumen occurred in both groups after stenting, and the aortic and false lumen diameter increased only at the level of the abdominal aorta in IIIB patients. The false lumen was thrombosed in 91% of IIIA vs 62% of IIIB patients at the mid-descending aorta. Intervention was required in 15% (6 of 39) of IIIA and in 26% (15 of 58) of IIIB patients. |
2 |
| 19. Eriksson MO, Steuer J, Wanhainen A, Thelin S, Eriksson LG, Nyman R. Morphologic outcome after endovascular treatment of complicated type B aortic dissection. J Vasc Interv Radiol. 24(12):1826-33, 2013 Dec. |
Observational-Tx |
51 patients |
To investigate the long-term morphologic changes of the aorta after thoracic endovascular aortic repair (TEVAR) for acute complicated type B aortic dissection and to analyze whether these changes differed between DeBakey class IIIa and IIIb dissections. |
There was an overall significant reduction of the thoracic aortic diameter, increased true lumen diameter, and reduced false lumen diameter (P < .05). Total thrombosis of the false lumen, with or without reintervention, was seen in 53% of all patients, in 41% primarily and in 12% after reintervention. The IIIa group had a higher degree of total false lumen thrombosis. All patients in the IIIb group had total thrombosis of the false lumen along the stent graft. |
2 |
| 20. Lombardi JV, Cambria RP, Nienaber CA, et al. Aortic remodeling after endovascular treatment of complicated type B aortic dissection with the use of a composite device design. J Vasc Surg. 59(6):1544-54, 2014 Jun. |
Observational-Tx |
86 patients |
To report updated clinical and aortic remodeling results from the Study for the Treatment of complicated Type B Aortic Dissection using Endoluminal repair (STABLE) trial, a prospective, multicenter study evaluating safety and effectiveness of a pathology-specific endovascular system (proximal stent graft and distal bare metal stent) for the treatment of complicated type B aortic dissection. |
The 30-day mortality rate was 4.7% (4/86) in the overall patient group (5.5% in acute patients and 3.2% in non-acute patients). Freedom from all-cause mortality was 88.3% at 1 year and 84.7% at 2 years (no significant difference between acute and nonacute patients). From baseline to 2 years, the true lumen diameter increased significantly in the descending thoracic aorta and the more distal abdominal aorta, along with a decrease in the false lumen diameter in both aortic segments. A majority of patients had either a stable or shrinking transaortic diameter in the thoracic (80.3% at 1 year and 73.9% at 2 years) or abdominal aorta (79.1% at 1 year and 66.7% at 2 years). Transaortic growth (>5 mm) occurred predominantly in acute dissections. Consistently, a shorter time from symptom onset to treatment was found to predict transaortic growth in the abdominal aorta (P = .03). |
2 |
| 21. Song SW, Kim TH, Lim SH, Lee KH, Yoo KJ, Cho BK. Prognostic factors for aorta remodeling after thoracic endovascular aortic repair of complicated chronic DeBakey IIIb aneurysms. J Thorac Cardiovasc Surg. 148(3):925-32, 933.e1; discussion 932-3, 2014 Sep. |
Observational-Tx |
20 patients |
To analyze the potential prognostic factors affecting aorta remodeling after thoracic endovascular aortic repair (TEVAR) for chronic DeBakery III type b (CDIIIb) aneurysms. |
All the patients had uneventful in-hospital courses; 2 patients (10%) required reintervention during the follow-up period. Thirteen patients (65%) had complete thrombosis of the FL at stent graft segment. Compared with the complete thrombosis group, the partial thrombosis group had more reentry tears (1.8 vs 2.3, P = .48), large intimal tears (0.8 vs 1.7, P < .05), visceral branches arising from the FL (1.2 vs 2.3, P < .05), and ICAs arising from the FL (3.8 vs 5.1, P = .35). Reentry tears, visceral branches, and ICAs from the FL were significant negative prognostic factors for FL shrinkage (P < .05). |
2 |
| 22. Weber TF, Bockler D, Muller-Eschner M, et al. Frequency of abdominal aortic expansion after thoracic endovascular repair of type B aortic dissection. Vascular. 24(6):567-579, 2016 Dec. |
Observational-Dx |
18 TEVAR patients with follow-up >36 months |
To determine abdominal aortic expansion after thoracic endovascular aortic repair (TEVAR) in patients with aortic dissection type B and 36 months minimum follow-up. |
Median follow-up was 75.2 months. Sixteen of 18 patients (88.9%) demonstrated abdominal expansion. Mean expansion was 9.9 ± 6.1 mm at B and 11.7 ± 6.5 mm at C, without a difference between acute and chronic dissections. Critical diameters of 55 mm were reached in two patients treated for chronic dissection (11.1%). Annual diameter increase was significantly greater at locations with baseline diameters >30 mm (2.1 ± 1.1 mm vs. 1.0 ± 0.6 mm, p = 0.009). Baseline diameters were greater in patients with chronic dissections. |
2 |
| 23. Yu B, Li T, Liu H. Retrospective analysis of factors associated with aortic remodeling in patients with Stanford type B aortic dissection after thoracic endovascular aortic repair. Journal Of Cardiothoracic Surgery. 16(1):190, 2021 Jul 07. |
Observational-Tx |
100 patients with acute type B aortic dissection |
To identify factors in patients with favorable and adverse aortic remodeling after TEVAR. |
The proportion of single-stent implantations was higher in the favorable remodeling group than in the adverse remodeling group (79.5% vs. 53.8% in distal end of stent-graft level and 81.3% vs. 56.4% in diaphragm level, respectively, p < 0.05). The earlier the TEVAR procedure was performed, the better the aortic remodeling (3.4 days vs. 4.8 days in distal stent graft levels, and 3.6 days vs. 4.9 days in diaphragm level, respectively, p < 0.05), the presence of residual distal entry tears in the abdominal aorta also improved aortic remodeling after TEVAR (85.7% vs. 55.1% in the celiac trunk level, and 92.0% vs. 48.9% in the right renal artery level, respectively, p < 0.05). |
2 |
| 24. Prescott-Focht JA, Martinez-Jimenez S, Hurwitz LM, et al. Ascending thoracic aorta: postoperative imaging evaluation. Radiographics 2013;33:73-85. |
Review/Other-Tx |
N/A |
To review several open-repair techniques and their indications, as well as their normal and abnormal postoperative appearances at computed tomographic (CT) angiography. |
Several abnormalities of the ascending aorta and aortic arch often require surgery, and various open techniques may be used to reconstruct the aorta, such as the Wheat procedure, in which both an ascending aortic graft and an aortic valve prosthesis are implanted; the Cabrol and modified Bentall procedures, in which a composite synthetic ascending aorta and aortic valve graft are placed; the Ross procedure, in which the aortic valve and aortic root are replaced with the patient's native pulmonary valve and proximal pulmonary artery; valve-sparing procedures such as the T. David-V technique, which leaves the native aortic valve intact; and more extensive arch repair procedures such as the elephant trunk and arch-first techniques, in which interposition or inclusion grafts are implanted, with or without replacement of the aortic valve. Normal postoperative imaging findings, such as hyperattenuating felt pledgets, prosthetic conduits, and reanastomosis sites, may mimic pathologic processes. Postoperative complications seen at CT angiography that require further intervention include pseudoaneurysms, anastomotic stenoses, dissections, and aneurysms. |
4 |
| 25. Nienaber CA, Sakalihasan N, Clough RE, et al. Thoracic endovascular aortic repair (TEVAR) in proximal (type A) aortic dissection: Ready for a broader application?. Journal of Thoracic & Cardiovascular Surgery. 153(2):S3-S11, 2017 02. |
Review/Other-Dx |
12 patients with acute, subacute, or chronic type A aortic dissection treated with TEVAR |
To describe a case series of type A aortic dissections treated by using TEVAR. |
A total of 12 patients (9 male, 3 female), mean age 81 ± 7 years, EuroSCORE II 9.1 ± 4.5, underwent TEVAR for the treatment of type A aortic dissection. Procedural success was achieved in 11 of 12 patients (91.7%). There was 1 minor stroke and 1 intraprocedural death. No additional deaths were reported at 30 days. At 36 months, there were 4 further deaths (all from nonaortic causes). The mean survival of these 4 deceased was 23 months (range 15-36 months). Follow-up computed tomography demonstrated favorable aortic remodeling. |
4 |
| 26. Piffaretti G, Galli M, Lomazzi C, et al. Endograft repair for pseudoaneurysms and penetrating ulcers of the ascending aorta. Journal of Thoracic & Cardiovascular Surgery. 151(6):1606-14, 2016 Jun. |
Review/Other-Dx |
8 patients with AAPs (n = 5) and PAUs (n = 3) |
To report midterm results of thoracic endovascular aortic repair (TEVAR) for ascending aortic pseudoaneurysms (AAPs) and penetrating aortic ulcers (PAUs) of the ascending aorta. |
Urgent intervention was performed in 6 (75%) cases. Primary clinical success was achieved in 7 (87.5%) cases. A low-flow type 3 endoleak remained asymptomatic and was managed conservatively. No TEVAR-related in-hospital mortality, primary conversion, cerebrovascular accidents, valve impairment, or myocardial infarction occurred. All patients were discharged home, alive and independent, after a median length of stay of 6 (range: 5-24) days. No patient was lost at a mean follow-up of 40 ± 33 (range: 4-93) months. Ongoing primary clinical success was maintained in all but 1 patient (type 3 endoleak): aortically related reintervention was never required. No endograft breakage or migration was observed. At 1-year follow-up, 7 (87.5%) aortic lesions had significant reduction in diameter (=5 mm). |
4 |
| 27. Mendoza DD, Kochar M, Devereux RB, et al. Impact of image analysis methodology on diagnostic and surgical classification of patients with thoracic aortic aneurysms. Ann Thorac Surg 2011;92:904-12. |
Observational-Dx |
50 subjects |
To examine the impact of methodological variance on aortic quantification. |
Fifty subjects were studied. Aortic size differed between AX and DO at all locations (p</=0.001), with magnitude greatest at the sinotubular junction (4.8+/-1.1 vs 4.0+/-1.0 cm, p<0.001). The difference between AX and DO correlated with aortic angular displacement (r=0.37, p<0.01), which was threefold larger at the sinotubular junction (37+/-12 degrees) than the ascending aorta (12+/-5 degrees; p<0.001). At all locations, aortic area calculated using DO yielded smaller differences with planimetry than AX (p<0.05). DO and planimetry yielded equal prevalence (24%) of subjects eligible for prophylactic TAA repair based on area-height cutoff, whereas AX prevalence was higher (44%; p=0.006). Using a linear cutoff, AX yielded over a twofold greater prevalence of surgically eligible subjects (56%) than did DO (24%; p<0.001). |
4 |
| 28. Cantinotti M, Giordano R, Clemente A, et al. Strengths and Limitations of Current Adult Nomograms for the Aorta Obtained by Noninvasive Cardiovascular Imaging. [Review]. Echocardiography. 33(7):1046-68, 2016 Jul. |
Review/Other-Dx |
N/A |
To evaluate the strengths and limitations of currently available aortic nomograms by echocardiography, computed tomography (CT), and magnetic resonance imaging (MRI). |
No results in abstract. |
4 |
| 29. Fleischmann D, Afifi RO, Casanegra AI, et al. Imaging and Surveillance of Chronic Aortic Dissection: A Scientific Statement From the American Heart Association. Circ Cardiovasc Imaging 2022;15:e000075. |
Review/Other-Dx |
N/A |
To present state-of-the-art imaging and measurement techniques for patients with chronic aortic dissection and clarify the need for standardized measurements and reporting for lifelong surveillance.To examine the emerging role of imaging and computer simulations to predict aortic false lumen degeneration, remodeling, and biomechanical failure from morphological and hemodynamic features. |
No results in abstract |
4 |
| 30. Watanabe S, Hanyu M, Arai Y, Nagasawa A. Initial medical treatment for acute type a intramural hematoma and aortic dissection. Annals of Thoracic Surgery. 96(6):2142-6, 2013 Dec.Ann Thorac Surg. 96(6):2142-6, 2013 Dec. |
Observational-Tx |
59 patients |
To evaluate short-term clinical outcomes and predictors of adverse outcomes. |
Survival, aortic death-free survival, and aortic event-free survival rates at 2 years were 90.0%, 96.6%, and 55.8%, respectively. Ascending aortic diameters, false lumen thickness of the ascending aortas, and rate of penetrating aortic ulcers in the ascending aortas were higher among patients with aortic events. The FTR of the ascending aorta (FTRA)/FTR of the descending aorta (FTRD) was also higher in these patients (1.3 +/- 0.9 versus 0.8 +/- 0.5, p = 0.0021). Multivariate analysis revealed FTRA/FTRD greater than 0.98 (odds ratio 5.35; 95% confidence interval: 0.05 to 1.72; p = 0.0431) as an independent predictor of aortic events. An FTRA/FTRD greater than 0.98 predicted aortic events with 87.1% sensitivity and 58.4% specificity. |
2 |
| 31. Nagpal P, Agrawal MD, Saboo SS, Hedgire S, Priya S, Steigner ML. Imaging of the aortic root on high-pitch non-gated and ECG-gated CT: awareness is the key! Insights Imaging 2020;11:51. |
Review/Other-Dx |
N/A |
To present a comprehensive review of proximal aortic anatomy, pathologies commonly seen at the aortic root, and their imaging appearances to familiarize radiologists with the diseases of this location. |
No results in abstract. |
4 |
| 32. Nagpal P, Mullan BF, Sen I, Saboo SS, Khandelwal A. Advances in Imaging and Management Trends of Traumatic Aortic Injuries. [Review]. Cardiovasc Intervent Radiol. 40(5):643-654, 2017 May. |
Review/Other-Dx |
N/A |
To highlight the imaging protocol in patients with blunt trauma, CT appearance and grading systems of ATAI, management options, and the role of the multidisciplinary team in the management of these patients.To review the current literature on the definition, treatment, and follow-up protocol in patients with minimal aortic injury. |
No results in abstract. |
4 |
| 33. Secchi F, Di Leo G, Zanardo M, Ali M, Cannao PM, Sardanelli F. Detection of incidental cardiac findings in noncardiac chest computed tomography. Medicine (Baltimore) 2017;96:e7531. |
Observational-Dx |
237 consecutive patients undergoing a noncardiac chest CT |
To estimate the rate of incidental cardiac findings (ICF) in patients undergoing noncardiac chest CT |
At review, =1 ICF was detected in 124/237 patients (52%), for a total of 229 ICF, 158 of them (69%) not originally mentioned. Valvular calcifications were unmentioned in 23/23 (100%) patients, main pulmonary artery dilation in 21/22 (96%), coronary calcifications in 69/86 (80%), right or left atrial dilation in 7/11 (64%), aortic atherosclerosis in 29/62 (47%), and ascending aorta dilatation in 8/18 (44%). All 6 pericardial effusions were originally mentioned. No association with sex (P = .189); positive correlation with age (P < .001).Half of patients undergoing noncardiac chest CT presented =1 ICF, independently from sex but increasing with age. Moreover, 69% of detectable ICFs were not originally mentioned. |
3 |
| 34. Stein E, Mueller GC, Sundaram B. Thoracic aorta (multidetector computed tomography and magnetic resonance evaluation). Radiol Clin North Am. 52(1):195-217, 2014 Jan. |
Review/Other-Dx |
N/A |
To review cross-sectional imaging of thoracic aorta. |
No results stated in abstract. |
4 |
| 35. Si-Mohamed S, Dupuis N, Tatard-Leitman V, et al. Virtual versus true non-contrast dual-energy CT imaging for the diagnosis of aortic intramural hematoma. European Radiology. 29(12):6762-6771, 2019 Dec. |
Observational-Dx |
21 patients |
To assess whether virtual non-contrast (VNC) images derived from contrast dual-layer dual-energy computed tomography (DL-DECT) images could replace true non-contrast (TNC) images for aortic intramural hematoma (IMH) diagnosis in acute aortic syndrome (AAS) imaging protocols by performing quantitative as well as qualitative phantom and clinical studies. |
In both the phantom and clinical studies, we observed that the CNRs were similar between the VNC and TNC images. Moreover, both methods allowed differentiating the hyper-attenuation within the hematoma from the blood. Finally, we obtained equivalent high diagnostic confidence with both VNC and TNC images (VNC = 3.2 ± 0.7, TNC = 3.1 ± 0.7; p = 0.3). Finally, by suppressing TNC acquisition and using VNC, the mean effective dose reduction would be 40%. |
3 |
| 36. Rengier F, Geisbusch P, Vosshenrich R, et al. State-of-the-art aortic imaging: part I - fundamentals and perspectives of CT and MRI. Vasa 2013;42:395-412. |
Review/Other-Dx |
N/A |
To describe the imaging principles of CT and MRI with regard to aortic disease, show how both technologies can be applied in every day clinical practice, offer exciting perspectives. |
No results stated in abstract. |
4 |
| 37. Bean MJ, Johnson PT, Roseborough GS, Black JH, Fishman EK. Thoracic aortic stent-grafts: utility of multidetector CT for pre- and postprocedure evaluation. Radiographics 2008;28:1835-51. |
Review/Other-Dx |
N/A |
To discuss which patients are potential candidates for thoracic aortic stent-graft placement and demonstrate how multidetector computed tomography (CT) with two-dimensional (2D) multiplanar reformation (MPR) and three-dimensional (3D) rendering is relevant in preoperative imaging and postoperative assessment of thoracic aortic stent-grafts. |
No results stated in abstract. |
4 |
| 38. Godoy MC, Cayne NS, Ko JP. Endovascular repair of the thoracic aorta: preoperative and postoperative evaluation with multidetector computed tomography. J Thorac Imaging. 26(1):63-73, 2011 Feb. |
Review/Other-Dx |
N/A |
To focus on the preoperative assessment of the pathologic aorta and evaluation after thoracic endovascular aortic repair. |
No results stated in abstract |
4 |
| 39. van Noort K, Schuurmann RCL, Post Hospers G, et al. A New Methodology to Determine Apposition, Dilatation, and Position of Endografts in the Descending Thoracic Aorta After Thoracic Endovascular Aortic Repair. Journal of Endovascular Therapy. 26(5):679-687, 2019 10. |
Observational-Dx |
22 patients with a degenerative descending thoracic aortic aneurysm treated with TEVAR with at least one postoperative CTA |
To validate computed tomography angiography (CTA)-applied software to assess apposition, dilatation, and position of endografts in the proximal and distal landing zones after thoracic endovascular aortic repair (TEVAR) of thoracic aortic aneurysm. |
Excellent interobserver agreement was found for all measurements. Interobserver variability of surface and shortest apposition length calculations was larger for the distal site compared with the proximal site, with a mean difference of 10% vs 2% of the mean available apposition surface, 12% vs 5% of the endograft apposition surface, and 16% vs 8% of the shortest apposition length, respectively. Inflow and outflow diameters of the endograft showed low variability, with a mean difference of 0.1 mm with 95% of the interobserver difference within 1.8 mm. Mean interobserver differences of the proximal and distal shortest fabric distances were 1.0 and 0.9 mm (both 2% of the mean lengths). |
3 |
| 40. Dux-Santoy L, Rodriguez-Palomares JF, Teixido-Tura G, et al. Registration-based semi-automatic assessment of aortic diameter growth rate from contrast-enhanced computed tomography outperforms manual quantification. European Radiology. 32(3):1997-2009, 2022 Mar. |
Observational-Dx |
40 patients with ≥ 2 CTA acquired at least 6 months apart |
To quantify accuracy and inter-observer reproducibility of registration-based and manual assessment of aortic diameters and growth rates. |
Compared with manual assessment, the registration-based technique presented low bias (0.46 mm), excellent agreement (ICC = 0.99), and similar inter-observer reproducibility (ICC = 0.99 for both) for aortic diameters; and low bias (0.10 mm/year), good agreement (ICC = 0.82), and much higher inter-observer reproducibility for growth rates (root: ICC = 0.96 vs 0.68; thoracic aorta: ICC = 0.96 vs 0.80). Registration-based growth rate reproducibility over a 6-month-long follow-up was similar to that obtained by manual assessment after 2.7 years (LoA = [- 0.01, 0.33] vs [- 0.13, 0.21] mm/year, respectively). Mapping of diameter and growth rate was highly reproducible (ICC > 0.9) in the whole thoracic aorta. |
2 |
| 41. Parodi J, Berguer R, Carrascosa P, Khanafer K, Capunay C, Wizauer E. Sources of error in the measurement of aortic diameter in computed tomography scans. Journal of Vascular Surgery. 59(1):74-9, 2014 Jan. |
Observational-Dx |
27 patients with gated and nongated CT angiograms |
To determine the differences in the diameter of the thoracic aorta when measured from electrocardiographic (ECG)-gated and nongated computed tomography (CT) angiography. To define the difference in the aortic diameter when it is measured at peak systole and end diastole in ECG-gated scans. |
There was a significant difference in the aortic measurements of diameter between gated and nongated scans found in samples taken at 1, 4, and 8 cm distal to the left subclavian artery (P < .0001). We found a considerable difference between the systolic and diastolic diameters (P < .0001). The maximum change in diameter between systole and diastole was 2.9 ± 0.9 (SD) mm (14.5%, P < .0001) at 1 cm, 5.4 mm (22.6%; median, 1.7 mm; P < .0001) at 4 cm, and 4.4 mm (16.9%; median, 1.3 mm; P < .0001) at 8 cm. There was a significant difference between the transverse and anteroposterior diameters in systole and diastole at all locations (P < .0001): The maximum change in diameter between transverse and anteroposterior diameters in systole was 5.4 ± 1.1 (SD) mm (15.7%, P < .0001) at 1 cm, 5.8 mm (19%; median, 1.4 mm; P < .0001) at 4 cm, and 5 mm (15%; median, 1.02 mm; P < .0001) at 8 cm. There was also a substantial difference between measuring the transverse diameter directly and deriving it from the lumen area (P < .0001). |
4 |
| 42. Lemos AA, Pezzullo JC, Fasani P, et al. Can the unenhanced phase be eliminated from dual-phase CT angiography for chest pain? Implications for diagnostic accuracy in acute aortic intramural hematoma. AJR. American Journal of Roentgenology. 203(6):1171-80, 2014 Dec. |
Observational-Dx |
306 patients |
To retrospectively assess the frequency of acute aortic intramural hematoma and evaluate whether the elimination of the unenhanced imaging acquisition series from the dual-phase MDCT angiography (CTA) protocol for chest pain might affect diagnostic accuracy in detecting intramural hematoma and justify the reduced radiation dose. |
Thirty-six patients were suspected of having intramural hematoma; 16 patients underwent both surgery and transesophageal echocardiography (TEE), and the remaining 20 underwent TEE. Single-phase CTA showed a higher number of false-negative and false-positive results than dual-phase CTA. With intramural hematoma frequency of 12% (95% CI, 8.38-15.91%), sensitivity, specificity, and accuracy were 94.4% (81.3-99.3%), 99.3% (97.4-99.9%), and 98.7% (96.7-99.6%) for combined dual-phase CTA and 68.4% (51.4-82.5%), 96.3% (93.2-98.2%), and 92.8% (89.3-95.4%) for single-phase CTA. Dual-phase was significantly better than single-phase CTA with respect to sensitivity (p=0.002), specificity (p=0.008), overall accuracy (p<0.001), and interrater agreement (p=0.001). |
2 |
| 43. Kaji S, Nishigami K, Akasaka T, et al. Prediction of progression or regression of type A aortic intramural hematoma by computed tomography. Circulation 1999;100:II281-6. |
Observational-Dx |
22 consecutive patients with type A IMH |
To investigate the predictors of progression or regression of type A aortic intramural hematoma (IMH) by computed tomography (CT). |
Twenty-two consecutive patients with type A IMH were studied by serial CT images. Aortic diameter and aortic wall thickness of the ascending aorta were estimated in CT images at 3 levels on admission and at follow-up (mean 37 days). We defined patients who showed increased maximum aortic wall thickness in the follow-up CT (n=9) or died of rupture (n=1) as the progression group (n=10). The other 12 patients, who all showed decreased maximum wall thickness, were categorized as the regression group. In the progression group, the maximum aortic diameter in the initial CT was significantly greater than that in the regression group (55+/-6 vs 47+/-3 mm, P=0.001). A Cox regression analysis revealed that the maximum aortic diameter was the strongest predictor for progression of type A IMH. We considered the optimal cutoff value to be 50 mm for the maximum aortic diameter to predict progression (positive predictive value 83%, negative predictive value 100%). |
3 |
| 44. Liu Z, Zhang Y, Liu C, et al. Treatment of serious complications following endovascular aortic repair for type B thoracic aortic dissection. Journal of International Medical Research. 45(5):1574-1584, 2017 Oct. |
Observational-Tx |
58 patients without Marfan syndrome who received TEVAR for type B aortic dissection |
To describe treatment of serious complications after primary thoracic endovascular aortic repair (TEVAR) in type B aortic dissection. |
Complications included endoleak, distal true lumen collapse, retrograde dissection, stroke, stent-graft (SG) migration and mistaken deployment, lower limb ischaemia, and SG fracture. Treatment included endovascular repair, surgical procedures, or conservative medication. Forty-six patients recovered from complications. Twelve patients were not cured. The median follow-up time was 29.5 months (2-61 months). The overall 30-day mortality rate was 1.7% (1/58) and the total mortality rate following secondary complications was 8.6% (5/58). The causes of death were stroke and aortic rupture. |
4 |
| 45. Snel GJH, Hernandez LM, Slart RHJA, et al. Validation of thoracic aortic dimensions on ECG-triggered SSFP as alternative to contrast-enhanced MRA. European Radiology. 30(11):5794-5804, 2020 Nov. |
Observational-Dx |
30 patients referred for thoracic aortic examination who underwent non-ECG-triggered CE-MRA and SSFP-MRA (1.5 T) |
To evaluate the similarity and reproducibility of dimensions measured on ECG-triggered, balanced steady-state free precession (SSFP) MRA as alternative to CE-MRA. |
Aortic dimensions showed high agreement between non-ECG-triggered CE-MRA and SSFP-MRA (r = 0.99, p < 0.05) without overestimation or underestimation of aortic dimensions in SSFP-MRA (mean difference, 0.1 mm; limits of agreement, - 1.9 mm and 1.9 mm). Intra- and inter-observer variabilities were significantly smaller with SSFP-MRA for the sinus of Valsalva and sinotubular junction. Image quality of the sinus of Valsalva was significantly better with SSFP-MRA, as fewer images were of impaired quality (3/30) than in CE-MRA (21/30). Reproducibility of dimensions was significantly better in images scored as good quality compared to impaired quality in both sequences. |
3 |
| 46. Smith LR, Darty SN, Jenista ER, et al. ECG-gated MR angiography provides better reproducibility for standard aortic measurements. European Radiology. 31(7):5087-5095, 2021 Jul. |
Observational-Dx |
53 patients that underwent both non-gated and ECG-gated CE-MRA |
To directly compared diameter measurements in the same patient from ECG-gated to non-gated CE-MRA to evaluate the impact of ECG gating upon measurement reproducibility. |
Image quality with ECG gating was rated significantly higher at the SOV (3.2 ± 0.9 vs 1.2 ± 1.0, p < 0.0001), STJX (3.4 ± 0.7 vs 1.8 ± 1.0, p < 0.0001), AAO (3.5 ± 0.6 vs 1.7 ± 1.1 p < 0.0001), DLSA (4.0 ± 0.1 vs 3.6 ± 0.7, p = 0.006), and DAO (4.0 ± 0.1 vs 3.4 ± 0.9 p < 0.0001) than for non-gated studies. Bland-Altman analyses demonstrated that inter- and intra-observer variability was significantly smaller for ECG-gated MRA at the SOV and AAO. For the non-gated images at the SOV, the 95% limits of agreement for both inter- and intra-observer variability exceeded the growth-rate cutoff for surgical repair (0.5 cm). At the DAO, variability was similar between the two techniques. |
1 |
| 47. Zhu C, Haraldsson H, Kallianos K, et al. Gated thoracic magnetic resonance angiography at 3T: noncontrast versus blood pool contrast. The International Journal of Cardiovascular Imaging. 34(3):475-483, 2018 Mar. |
Observational-Dx |
45 patients: 23 after administration of iron-based blood pool contrast and 22 without contrast |
To compare qualitative and quantitative image quality measures for the two approaches, and assess the reproducibility of standard aortic measurements. |
Interrater agreement was assessed using Bland-Altman plots and coefficient of variation (CV). Qualitative image quality was better with blood pool contrast in all principal vessels of the chest (mean Likert of 4.20 ± 0.79 vs. 2.60 ± 0.77, p < 0.001). Quantitative assessment was also improved with higher contrast ratios in all vessels (5.26 ± 3.3 vs. 1.90 ± 0.53, p < 0.001), and greater sharpness of the aortic annulus and ascending aorta (0.70 ± 0.16 vs. 0.56 ± 0.14 mm-1, p < 0.001, and 0.87 ± 0.16 vs. 0.62 ± 0.16 mm-1, p = 0.008, respectively). Reproducibility of measurement was marginally better for the ascending aorta diameter (CV of 2.80 vs. 3.23%), but substantially increased for the aortic valve annulus area with blood pool contrast (CV of 4.93 vs. 7.32%). |
2 |
| 48. Frazao C, Tavoosi A, Wintersperger BJ, et al. Multimodality Assessment of Thoracic Aortic Dimensions: Comparison of Computed Tomography Angiography, Magnetic Resonance Imaging, and Echocardiography Measurements. Journal of Thoracic Imaging. 35(6):399-406, 2020 Nov 01. |
Observational-Dx |
127 patients who had undergone CT and MRI evaluation of the thoracic aorta |
To compare thoracic aortic measurements between computed tomography (CT), magnetic resonance imaging (MRI), and transthoracic echocardiography (TTE). |
There was no significant difference in maximum aortic root diameter between CT and MRI when using the inner lumen-to-inner lumen technique (mean difference: 0.2±1.4 mm, P=0.51) or the outer lumen-to-outer lumen technique (mean difference: 0.5±1.4 mm, P=0.07). There were no significant differences between CT and MRI at any other level except for the distal descending aorta (20.2±4.6 vs. 19.8±4.6 mm, P<0.001). However, aortic root measurements by TTE using the leading edge-to-leading edge technique were significantly smaller compared with maximum aortic root diameters using the inner lumen-to-inner lumen and outer lumen-to-outer lumen techniques by both CT (mean difference: 4.9±2.7 mm, P<0.001 and 7.4±2.8 mm, P<0.001, respectively) and MRI (mean difference: 4.8±3.2 mm, P<0.001 and 8.2±3.0 mm, P<0.001, respectively). |
3 |
| 49. Wang GX, Hedgire SS, Le TQ, et al. MR angiography can guide ED management of suspected acute aortic dissection. Am J Emerg Med. 35(4):527-530, 2017 Apr. |
Review/Other-Dx |
50 patients with MRA ordered for evaluation of suspected acute thoracic aortic dissection |
To examine the indications and outcomes of MRA in suspected aortic dissection evaluation in the ED. |
50 MRAs were ordered for suspected thoracic aortic dissection. 21 (42%) for iodinated contrast allergy, 21 (42%) for renal insufficiency, 2 (4%) due to both, 2 (4%) to spare ionizing radiation, 2 (4%) for further work-up after CTA, and 2 (4%) due to prior contrast enhanced CT within 24h. Median ED arrival to MRA completion time was 311min. 42 studies were fully diagnostic; 7 were limited. One patient could not tolerate the examination. 49 MRAs were completed: 2 (4%) patients had acute dissection on MRA and 47 (96%) had negative exams. 17 (35%) received gadolinium. 18 (37%) patients were discharged home from the ED with a median length of stay of 643min. 2 (4%) were admitted for acute dissection seen on MRA and 29 (59%) for further evaluation. |
4 |
| 50. Pennig L, Wagner A, Weiss K, et al. Comparison of a novel Compressed SENSE accelerated 3D modified relaxation-enhanced angiography without contrast and triggering with CE-MRA in imaging of the thoracic aorta. The International Journal of Cardiovascular Imaging. 37(1):315-329, 2021 Jan. |
Observational-Dx |
30 patients |
To compare a novel Compressed SENSE accelerated ECG- and respiratory-triggered flow-independent 3D isotropic Relaxation-Enhanced Angiography without Contrast and Triggering (modified REACT) with standard non-ECG-triggered 3D contrast-enhanced magnetic resonance angiography (CE-MRA) for imaging of the thoracic aorta in patients with connective tissue diseases (CTD) or other aortic diseases using manual and semiautomatic measurement approaches. |
When comparing both imaging and measurement methods, CE-MRA (mean difference 0.24 ± 0.27 mm) and the AVA-tool (- 0.21 ± 0.15 mm) yielded higher differences compared to modified REACT (- 0.11 ± 0.11 mm) and the MPR-tool (0.07 ± 0.21 mm) for all measurement levels combined without yielding clinical significance. There was an excellent interobserver agreement between modified REACT and CE-MRA using both tools of measurement (ICC > 0.9). Modified REACT (average acquisition time 06:34 ± 01:36 min) provided better image quality from aortic annulus to mid-ascending aorta (p < 0.05), whereas at distal measurement levels, no significant differences were noted. Regarding time requirement, no statistical significance was found between both measurement techniques (p = 0.08). As a novel non-CE-MRA technique, modified REACT allows for fast imaging of the thoracic aorta with higher image quality in the proximal aorta than CE-MRA enabling a reliable measurement of vessel dimensions without the need for contrast agent. Thus, it represents a clinically suitable alternative for patients requiring repetitive imaging. Manual and semiautomatic measurement approaches provided comparable results without significant difference in time need. |
3 |
| 51. Veldhoen S, Behzadi C, Lenz A, et al. Non-contrast MR angiography at 1.5 Tesla for aortic monitoring in Marfan patients after aortic root surgery. Journal of Cardiovascular Magnetic Resonance. 19(1):82, 2017 Oct 30. |
Observational-Dx |
64 adult Marfan patients |
To assess the feasibility of non-contrast balanced steady-state free precession (bSSFP) magnetic resonance imaging for aortic monitoring of postoperative patients with Marfan syndrome. |
Both readers observed no significant differences in image quality between bSSFP and CE-CMRA and found a median image quality score of 4 for both techniques (all p > .05). No significant differences were found regarding the frequency of image artifacts in both sequences (all p > .05). Sensitivity and specificity for detection of aortic dissections was 100% for both readers and techniques. Compared to bSSFP imaging, CE-CMRA resulted in higher diameters (mean bias, 0.9 mm; p < .05). The inter-observer biases of diameter measurements were not significantly different (all p > .05), except for the distal graft anastomosis (p = .001). Using both techniques, the readers correctly identified a graft suture dehiscence with aneurysm formation requiring surgery. |
2 |
| 52. Lim RP, Singh SG, Hornsey E, et al. Highly Accelerated Breath-Hold Noncontrast Electrocardiographically- and Pulse-Gated Balanced Steady-State Free Precession Magnetic Resonance Angiography of the Thoracic Aorta: Comparison With Electrocardiographically-Gated Computed Tomographic Angiography. Journal of Computer Assisted Tomography. 43(2):323-332, 2019 Mar/Apr. |
Observational-Dx |
31 patients underwent ECG-MRA, P-MRA, and CTA |
To evaluate agreement of measured thoracic aortic caliber in patients with aortic disease, using electrocardiographically-(ECG) and pulse-gated breath-hold noncontrast balanced steady-state free precession MRA (ECG-MRA, P-MRA) at 1.5 T, compared with ECG-gated computed tomographic angiography (CTA). |
There was overall excellent agreement among ECG-MRA, P-MRA, and CTA for measured aortic caliber (Lin's concordance correlation coefficient =0.94, all comparisons); however, lower concordance was noted at the annulus (Lin's concordance correlation coefficient <0.6) at segmental assessment. There was excellent interreader agreement for aortic caliber for all 3 techniques (intraclass correlation coefficient >0.94). Image quality was poorer for both MRA techniques compared with CTA, particularly at the aortic root. |
2 |
| 53. Zhou C, Qiao H, He L, et al. Characterization of atherosclerotic disease in thoracic aorta: A 3D, multicontrast vessel wall imaging study. European Journal of Radiology. 85(11):2030-2035, 2016 Nov. |
Observational-Dx |
66 patients ≥ 60-years-old |
To investigate the characteristics of plaque in the thoracic aorta using three dimensional multicontrast magnetic resonance imaging. |
Of 66 recruited subjects (mean age 72.3±6.2years, 30 males), 55 (83.3%) had plaques in the thoracic aorta. The prevalence of plaque in AAO, AOA, and DAO was 5.4%, 72.7%, and 71.2%, respectively. In addition, 21.2% of subjects were found to have lesions with IPH/MT in the thoracic aorta. The prevalence of IPH/MT in segment of AAO, AOA and DAO was 0%, 13.6%, and 12.1%, respectively. The aortic wall showed the highest NWI in DAO (34.1%±4.8%), followed by AOA (31.2%±5%), and AAO (26.8%±3.3%) (p<0.001). |
3 |
| 54. D'Abate F, Oladokun D, La Leggia A, et al. Transthoracic Ultrasound Evaluation of Arch and Descending Thoracic Aortic Pathology. European Journal of Vascular & Endovascular Surgery. 55(5):658-665, 2018 05. |
Observational-Dx |
39 Patients |
To investigate the feasibility of using an optimized duplex ultrasonography (DUS) protocol to detect descending thoracic aortic pathology. |
Forty patients were scanned (20 cases and 20 controls). All patients but one had a technically adequate assessment of the thoracic aorta (at least one view of the descending thoracic aorta). Using a size threshold of 40 mm, 16 out of 19 cases and two out of 20 control patients would have been recommended for definitive imaging. Using a cutoff of 35 mm, this became 18 out of 19 cases and six of 20 controls. Sensitivity and specificity were 100% and 70% for a threshold of 35 mm, and 84% and 90% for a threshold of 40 mm. |
3 |
| 55. Ghulam Ali S, Fusini L, Dalla Cia A, et al. Technological Advancements in Echocardiographic Assessment of Thoracic Aortic Dilatation: Head to Head Comparison Among Multidetector Computed Tomography, 2-Dimensional, and 3-Dimensional Echocardiography Measurements. Journal of Thoracic Imaging. 33(4):232-239, 2018 Jul. |
Observational-Dx |
50 consecutive patients with AA dilation |
To evaluate the feasibility and accuracy of 2-dimensional (2D) and 3-dimensional (3D) transthoracic echocardiography (2DTTE, 3DTTE) versus multidetector computed tomography (MDCT) in patients with ascending aortic (AA) dilation. |
Feasibility, quality of imaging, and accuracy was high with all echocardiographic methods. Specifically for MDCT maximum SIN diameter, the best correlation and agreement was obtained using XP maximum diameter at 3DTTE (MDCT: 44.8±7.4 mm vs. XP: 44.4±7.4 mm; r=0.975; bias=-0.4 mm). The same was true for AA maximum diameter at MDCT (MDCT: 46.6±8.1 mm vs. XP: 47.5±8.1 mm; r=0.991; bias=0.1 mm). For aortic arch the best correlation and agreement with MDCT were as follows: 2DTTE L-L diameter for arch PRE (MDCT: 37.9±5.3 mm vs. TTE: 36.6±4.5 mm; r=0.927; bias=-0.9 mm) and MDCT minimum diameter with XP minimum diameter for arch INTRA (MDCT: 28.2±5.0 mm vs. TTE 28.8±4.7 mm; r=0.939; bias=-0.3 mm). |
1 |
| 56. Saadi EK, Tagliari AP, Almeida RMS. Endovascular Treatment of the Ascending Aorta: is this the Last Frontier in Aortic Surgery? Brazilian Journal of Cardiovascular Surgery. 34(6):759-764, 2019 12 01. |
Observational-Tx |
N/A |
To discuss ascending aorta TEVAR as the final frontier of endovascular therapy. |
No results in abstract. |
4 |
| 57. Oderich GS, Picada-Correa M, Pereira AA. Open surgical and endovascular conduits for difficult access during endovascular aortic aneurysm repair. Ann Vasc Surg 2012;26:1022-9. |
Review/Other-Tx |
N/A |
To summarize open surgical and endovascular alternatives to dealing with difficult iliofemoral access during endovascular aortic interventions. |
No results stated in abstract. |
4 |
| 58. Botta L, Bruschi G, Fratto P, et al. Direct Transaortic TEVAR: An Alternative Option for Selected Patients With Unsuitable Peripheral Access. Annals of Thoracic Surgery. 102(2):e117-9, 2016 Aug. |
Review/Other-Dx |
2 cases |
To report 2 successful cases of direct transaortic TEVAR, where stent grafts were directly introduced into the native ascending aorta without external conduits. |
A satisfactory result and the absence of aortic-related complications were observed at 2 and 5 years' follow-up, respectively. |
4 |
| 59. Fujii K, Saga T, Onoe M, et al. Antegrade thoracic endovascular aneurysm repair via the ascending aorta. Asian Cardiovascular and Thoracic Annals. 27(3):163-171, 2019 Mar. |
Review/Other-Tx |
16 consecutive patients who underwent antegrade endovascular aneurysm repair via the ascending aorta |
To performed antegrade thoracic endovascular aneurysm repair via the ascending aorta in selected high-risk patients scheduled for open surgery, in whom an iliofemoral or abdominal aortic approach was not feasible.To present our initial experience with this approach. |
The initial success rate was 100%. Early mortality occurred in 2 (12.5%) patients because of multiple organ failure in one and heart failure in the other. No patient required a second intervention during follow-up. The mean duration of follow-up was 19 months. |
4 |
| 60. Murakami T, Nishimura S, Hosono M, et al. Transapical Endovascular Repair of Thoracic Aortic Pathology. Annals of Vascular Surgery. 43:56-64, 2017 Aug. |
Review/Other-Dx |
6 cases undergoing transapical access for endovascular repair of thoracic aortic pathology |
To review cases undergoing transapical thoracic endovascular aortic repair (TEVAR) and evaluated the feasibility, safety, and pitfalls of this approach. |
Transapical endografting was completed in all patients. Significant aortic valve regurgitation occurred in 3 patients when a large bore sheath was placed across the aortic valve. There was 1 death attributed to global cerebral ischemia due to carotid dissection after carotid bypass and chimney stent-graft insertion. There were no access-related complications. Computed tomography revealed complete exclusion of the aortic aneurysm in 4 patients, and shrinkage of the false lumen in 1 patient with aortic dissection. |
4 |
| 61. Steinberger JD, McWilliams JP, Moriarty JM. Alternative Aortic Access: Translumbar, Transapical, Subclavian, Conduit, and Transvenous Access to the Aorta. Techniques in Vascular & Interventional Radiology. 18(2):93-9, 2015 Jun. |
Review/Other-Dx |
N/A |
To outline techniques and approaches in this article that may allow expansion of endovascular treatments to greater patient populations and disease states than previously thought feasible. |
No results in abstract. |
4 |
| 62. Clarencon F, Di Maria F, Cormier E, et al. Comparison of intra-aortic computed tomography angiography to conventional angiography in the presurgical visualization of the Adamkiewicz artery: first results in patients with thoracoabdominal aortic aneurysms. Neuroradiology. 55(11):1379-87, 2013 Nov. |
Observational-Dx |
30 patients |
To compare the sensitivity of intra-aortic computed tomography angiography (IA-CTA) to that of regular spinal digital subtraction angiography for the presurgical location of the Adamkiewicz artery (AKA). |
The AKA was visualized by the IA-CTA in 27/30 cases (90 %); in 26/31 (84 %) cases, the continuity with the aorta was satisfactorily seen. Interrater agreement was good for the visualization of the AKA and its feeder(s): 0.625 and 0.87, respectively. In 75 % of the cases for which the AKA was visualized, the selective catheterization confirmed the results of the IA-CTA. In the remaining 25 % of the cases, the selective catheterization could not be performed due to marked vessels' tortuosity or ostium stenosis. |
2 |
| 63. Finlay A, Johnson M, Forbes TL. Surgically relevant aortic arch mapping using computed tomography. Ann Vasc Surg. 26(4):483-90, 2012 May. |
Review/Other-Tx |
45 patients |
To map the aortic arch diameters, branch orientations, and center line distances using a commercially available three-dimensional computed tomography-based software package and to propose a prototype design. |
The mode of the proximal diameters (2 cm and 4 cm distal to coronary artery) was 32 mm and 34 mm. The mode of the distance between the innominate and left common carotid arteries was 5 mm and 6 mm, and the mode of the distance between the left common carotid artery and left subclavian artery was 8 mm. Most commonly, the left common carotid artery was anterior to the other arch branches by 3 to 5 mm. |
4 |
| 64. Ueda T, Takaoka H, Raman B, Rosenberg J, Rubin GD. Impact of quantitatively determined native thoracic aortic tortuosity on endoleak development after thoracic endovascular aortic repair. AJR Am J Roentgenol 2011;197:W1140-6. |
Observational-Dx |
40 patients |
To assess whether there is an association between native thoracic aortic curvature and the development of endoleaks after thoracic endovascular aortic repair. |
Compared with patients without endoleaks, the tortuosity index of the proximal fixation zone was higher in patients with type Ia endoleak (9.5 vs 1.5 cm(-1), p < 0.01); the tortuosity index of the distal fixation zone was higher in type Ib endoleak patients (6.6 vs 0.5 cm(-1), p < 0.05); and the tortuosity indexes of the proximal fixation zone and of the diseased segment were higher in type III endoleak patients (11.0 vs 1.5 cm(-1), p < 0.01; and 15.8 vs 7.2 cm(-1), p < 0.01, respectively). Patients with a type III endoleak had longer diseased segments and larger mean diameters of the aneurysm than patients without endoleaks (148.6 vs 87.1 mm, p < 0.01; and 75.4 vs 63.2 mm, p < 0.05, respectively). Logistic regression analysis revealed that the risk of a type I or type III endoleak increased as the tortuosity index increased, with a 90% risk of endoleak at a tortuosity index of 10 cm(-1) in the proximal fixation zone. |
2 |
| 65. Chen CK, Liang IP, Chang HT, et al. Impact on outcomes by measuring tortuosity with reporting standards for thoracic endovascular aortic repair. J Vasc Surg. 60(4):937-44, 2014 Oct. |
Observational-Tx |
77 patients |
To assess the association between the tortuosity of the thoracic aorta as measured by the reporting standards for thoracic endovascular aortic repair (TEVAR), described by the Society for Vascular Surgery, and midterm outcomes after TEVAR for atherosclerotic aneurysms. |
The mean follow-up period was 29 +/- 26 months. During this period, endoleaks occurred in 19 patients. Patients in the high-tortuosity group were at greater risk for endoleaks (odds ratio, 9.95; 95% confidence interval, 2.06-48.1; P = .004) and stroke (odds ratio, 13.2; 95% confidence interval, 1.03-169; P = .047) than those in the low-tortuosity group. The overall survival at 1, 3, and 5 years was 73%, 69%, and 63%, respectively, for the high-tortuosity group and 92%, 92%, and 86%, respectively, for the low tortuosity group. |
2 |
| 66. Hsu HL, Chen CK, Chen PL, et al. The impact of bird-beak configuration on aortic remodeling of distal arch pathology after thoracic endovascular aortic repair with the Zenith Pro-Form TX2 thoracic endograft. J Vasc Surg. 59(1):80-8, 2014 Jan. |
Observational-Tx |
19 patients |
To analyze the morphologic changes, conformability, and angulation factors in patients who underwent stainless steel-based stent graft repair of thoracic aortic pathology. |
The treated diseases included chronic type B aortic dissection in 17 patients and degenerative aneurysms in 21. Significant arch angle transformation was noted at the zone 2 level between the Pro-Form and Z-Trak treated groups (150 degrees +/- 11 degrees vs 158 degrees +/- 6 degrees ; P = .033) and left subclavian artery level (152 degrees +/- 12 degrees vs 160 degrees +/- 8 degrees ; P = .031) during 1 year of follow-up. The bird-beak configuration was detected in six patients (32%) in the Pro-Form group and in 11 (58%) in the Z-Trak group (P = .096) at 1 month, and in six (32%) in the Pro-Form group and in 14 (74%) in the Z-Trak group (P = .022) at 12 months. The mean bird-beak angle was significantly less in Pro-Form-treated patients at 1 month (5 degrees +/- 9 degrees vs 15 degrees +/- 13 degrees ; P = .019) and at 1 year (6 degrees +/- 10 degrees vs 18 degrees +/- 15 degrees ; P = .033). In the Pro-Form platform, a preoperative zone 2 angle <151.1 degrees was a better estimation of the presence of a postoperative bird-beak configuration, with a sensitivity of 86% and specificity of 83%. |
2 |
| 67. Kudo T, Kuratani T, Shimamura K, et al. Type 1a endoleak following Zone 1 and Zone 2 thoracic endovascular aortic repair: effect of bird-beak configuration. European Journal of Cardio-Thoracic Surgery. 52(4):718-724, 2017 Oct 01. |
Observational-Tx |
105 patients who underwent Zone 1 and 2 landing TEVAR (32 patients in Group B; 73 patients in Group N) |
To analyse the predictors of Type 1a endoleak following Zone 1 and Zone 2 TEVAR, with a particular focus on the effect of bird-beak configuration. |
The Kaplan-Meier event-free rate curve showed that Type 1a endoleak and bird-beak progression occurred less frequently in Group N than in Group B. Five-year freedom from Type 1a endoleak rates were 79.7% and 100% for Groups B and N, respectively (P = 0.007). Multivariable logistic regression analysis showed that dissecting aortic aneurysm (odds ratio 3.72, 95% confidence interval 1.30-11.0; P = 0.014) and shorter radius of inner curvature (odds ratio 1.09, 95% confidence interval 0.85-0.99; P = 0.025) were significant risk factors for bird-beak configuration. Multivariable Cox proportional hazard regression showed that Z-type stent graft (hazard ratio 2.69, 95% confidence interval 1.11-6.51; P = 0.030) was a significant risk factor for bird-beak progression. |
2 |
| 68. Yacoub B, Stroud RE, Piccini D, et al. Measurement accuracy of prototype non-contrast, compressed sensing-based, respiratory motion-resolved whole heart cardiovascular magnetic resonance angiography for the assessment of thoracic aortic dilatation: comparison with computed tomography angiography. Journal of Cardiovascular Magnetic Resonance. 23(1):7, 2021 02 08. |
Observational-Dx |
24 patients with thoracic aortic dilatation underwent clinical CTA and research 1.5T CMRA |
To evaluate the feasibility of a non-contrast, respiratory motion-resolved whole-heart cardiovascular magnetic resonance angiography (CMRA) technique against reference standard CTA, for the quantitative assessment of cardiovascular anatomy and monitoring of disease progression in patients with thoracic aortic dilatation. |
Area, circumference and diameter measurements on a per-level analysis showed good or excellent agreement between CTA and CMRA (ICCs > 0.84). Means of differences on Bland-Altman plots were: area 0.0 cm2 [- 1.7; 1.6]; circumference 1.0 mm [- 10.0; 12.0], and diameter 0.6 mm [- 2.6; 3.6]. Area and diameter measurements of the left cardiac chambers showed good agreement (ICCs > 0.80), while moderate to good agreement was observed for the right chambers (all ICCs > 0.56). Similar good to excellent inter-modality agreement was shown for the pulmonary arteries and veins (ICC range 0.79-0.93), with the exception of the left lower pulmonary vein (ICC < 0.51). Inter-reader assessment demonstrated mostly good or excellent agreement for both CTA and CMRA measurements on a per-level analysis (ICCs > 0.64). Difference in maximum aortic diameter measurements at baseline vs follow up showed excellent agreement between CMRA and CTA (ICC = 0.91). |
1 |
| 69. Davila-Roman VG, Phillips KJ, Daily BB, Davila RM, Kouchoukos NT, Barzilai B. Intraoperative transesophageal echocardiography and epiaortic ultrasound for assessment of atherosclerosis of the thoracic aorta. J Am Coll Cardiol 1996;28:942-7. |
Observational-Dx |
44 patients evaluatedwith two ultrasound techniques-epiaortic ultrasound and biplane TEE-and by palpation |
To determine the role of transesophageal echocardiography (TEE) and epiaortic ultrasound in the detection of atherosclerosis of the ascending aorta in patients undergoing cardiac surgery. |
A comparison of results with biplane TEE and those with epiaortic ultrasound yielded a kappa value of 0.12 (95% confidence interval 0 to 0.25), indicating poor correlation between the two. Compared with epiaortic ultrasound, biplane TEE significantly underestimated the severity of ascending aortic atherosclerosis, and this underestimation was more marked in the distal ascending aorta (p < 0.0001). When compared with epiaortic ultrasound and biplane TEE, palpation of the ascending aorta significantly underestimated the presence and severity of atherosclerosis (p < 0.0001 for both). |
3 |
| 70. Carminati MC, Piazzese C, Weinert L, et al. Reconstruction of the descending thoracic aorta by multiview compounding of 3-D transesophageal echocardiographic aortic data sets for improved examination and quantification of atheroma burden. Ultrasound in Medicine & Biology. 41(5):1263-76, 2015 May. |
Observational-Dx |
17 consecutive patients |
To present for the first time a compounding approach in which 3-D TEE aortic data sets are combined to allow reconstruction of the descending aorta. |
For the 17 consecutive patients, 170 3-D TEE data sets were acquired and 153 pairwise registrations consequently computed. All pairs of registered data sets were visually checked by an experienced observer, as described under Clinical Validation, and 90.2% (138/153) were judged reliable for correspondence of aortic wall and atheromas, when present. The remaining 9.8% of cases (15/153), in which the registration did not lead to satisfactory results, were excluded from the following image fusion process. In particular, of the 15 failed pairwise registrations, 6 belonged to the same patient, for whom 11 consecutive data sets in total acquired. For this patient, successful aortic reconstruction was performed using only five consecutive volumes. The remaining failure cases belonged to different patients, and the relevant volumes were excluded from the reconstruction. In case the excluded data set was at the extremities of the acquisition chain (i.e., first or last acquired pyramidal volume), very few disadvantages were found in the final reconstruction because of the large amount of overlap of consecutive volumes (with a loss of approximately 1 cm, in accordance with the acquisition protocol). In case the failed registration corresponded to the ith data set located in the middle of the acquisition chain, the registration was re-computed between the (i + 1)th and (i - 1)th data sets, resulting in success. |
3 |
| 71. An KR, de Mestral C, Tam DY, et al. Surveillance Imaging Following Acute Type A Aortic Dissection. Journal of the American College of Cardiology. 78(19):1863-1871, 2021 11 09. |
Observational-Dx |
888 patients who survived urgent acute type A aortic dissection (ATAAD) repair |
To define the real-world frequency of postoperative imaging and characterize long-term outcomes of ATAAD. |
A total of 888 patients who survived urgent ATAAD repair between April 1, 2005, and March 31, 2018, were included. Median follow-up after ATAAD repair was 5.2 years (interquartile range: 2.4-7.9 years). A total of 14% patients received GDIS throughout follow-up. At 6 years, 3.9% of patients had received GDIS. The mortality rate was 4% at 1 year, 14% at 5 years, and 29% at 10 years. Incidence of aortic reintervention was 3% at 1 year, 9% at 5 years, and 17% at 10 years; the majority of these were urgent (68%), and they carried a 9% 30-day mortality rate. Greater adherence to GDIS was associated with mortality (hazard ratio: 1.08; 95% confidence interval: 1.05-1.11) and reintervention (hazard ratio: 1.04; 95% confidence interval: 1.01-1.07). |
4 |
| 72. Meena RA, Benarroch-Gampel J, Leshnower BG, et al. Surveillance Recommendations after Thoracic Endovascular Aortic Repair Should Be Based on Initial Indication for Repair. Annals of Vascular Surgery. 57:51-59, 2019 May. |
Observational-Dx |
262 patients that have undergone TEVAR (aneurysm=105 patients, dissection=103, PAU/IMH=36, transection=18) |
To hypothesize that certain initial indications for repair (i.e., transection) would correlate with decreased compliance with suggested surveillance post-TEVAR, based on the 2010 American College of Cardiology/American Heart Association (ACCF/AHA) management guidelines for thoracic aortic disease.To postulate that lower socioeconomic status, as represented primarily by minority race and uninsured status, would correlate with decreased compliance.To hypothesize that decreased compliance would be associated with increased aorta-specific complication rates. |
A total of 262 patients were included; of whom, 203 (77.5%) received at least one postoperative contrast-enhanced CT scan. Race, insurance status, and distance to hospital were not associated with 12-month compliance or compliance score (all P > 0.05). Regarding 12-month compliance, 76.2% of aneurysm patients, 81.6% of dissection patients, 72.2% of transection patients, and 72.2% of penetrating aortic ulcer patients underwent at least 1 CT scan within the first year (all P > 0.05). There were no differences in compliance score based on indication for repair. The overall aorta-related complication rate was 34.7%. TEVAR for dissection was associated with increased long-term aorta-specific complications (49.5%, P < 0.05 when compared with other indications). |
4 |
| 73. Schuurmann RCL, De Rooy PM, Bastos Goncalves F, Vos CG, De Vries JPM. A systematic review of standardized methods for assessment of endograft sealing on computed tomography angiography post-endovascular aortic repair, and its influence on endograft-associated complications. Expert Review of Medical Devices. 16(8):683-695, 2019 Aug. |
Review/Other-Dx |
13 studies |
To provide an overview of standardized meth-ods to assess the position of the endograft relative to ananatomical landmark and the apposition of the endograftonto the arterial wall at the proximal and distal landing zones on the CTA scan after EVAR and thoracic EVAR(TEVAR).To review validation of measurement precision and association of measured variables with endograft-associated complications. |
Quantification of apposition and position, validation of measurement precision, and association with endograft-related complications were extracted. Short (<10 mm apposition length) and decreasing (>0 mm) apposition were associated with endograft-associated complications. Standardized assessment of apposition and position of the endograft in the proximal and distal landing zones on CTA should be incorporated in post-(T)EVAR surveillance. A risk-stratified CTA surveillance protocol is proposed. |
4 |
| 74. Pang H, Chen Y, He X, et al. Twelve-Month Computed Tomography Follow-Up after Thoracic Endovascular Repair for Acute Complicated Aortic Dissection. Annals of Vascular Surgery. 71:444-450, 2021 Feb. |
Observational-Dx |
56 patients (2 type IIIA aortic dissection [AD] and 54 type IIIB AD) |
To explore the impact of thoracic endovascular aortic repair (TEVAR) on aortic remodeling (AR) and the relationship between AR and complications after TEVAR. |
The volume of the thoracic aortic true lumen gradually increased post-TEVAR, whereas the volume of the thoracic aortic false lumen gradually decreased. The volume of abdominal aortic total lumen and false lumen increased 6 months postoperatively. The AR index increased significantly 3 months postoperatively, which was negatively correlated with complications and mortality. The thoracic and abdominal aortic false lumen thrombosis developed gradually after TEVAR, and the degree of thoracic aortic false lumen thrombosis was negatively correlated with complications and mortality. |
2 |
| 75. Zhang MH, Du X, Guo W, Liu XP, Jia X, Ge YY. Early and midterm outcomes of thoracic endovascular aortic repair (TEVAR) for acute and chronic complicated type B aortic dissection. Medicine. 96(28):e7183, 2017 Jul. |
Observational-Dx |
85 patients divided into acute aortic dissection (AAD) (n = 60) group and chronic aortic dissection (CAD) group (n = 25) |
To assess safety and feasibility of TEVAR in acute and chronic type B aortic dissection. |
Computed tomography was used to evaluate postoperative changes in maximal aortic diameter and true and false lumen diameters at 3 levels during a mean follow-up period of 26.4 ± 15.6 months.The technical success rate was 100%. In-hospital and 30-day rates of death were 3.3% in acute group and 0 in chronic group. Postdischarge rates of type I leak, type II leak, and retrograde type A dissection were 6.7%, 5.2%, and 3.4% (acute) and 0%, 4.0%, and 4.0% (chronic), respectively. The maximal aorta diameter remained stable in all the 3 levels in both acute and chronic group. The cumulative freedom from all-cause mortality at 3 years was similar in acute and chronic groups (89.5% vs 95.5%, P = .308). The cumulative freedom from aortic-related mortality was also not significantly different in the acute and chronic groups (92.8% vs 95.2%, P = .531). In the thoracic aorta, TEVAR treatment resulted in a significant increase in true lumen (TL) diameter and decrease in false lumen (FL). However, in the abdominal aorta, TEVAR did not lead to significant change in TL and FL diameters. The rates of complete thrombosis thoracic false lumens were better than that in the abdominal false lumen. |
2 |
| 76. Wang XL, Huang HY, Li Z, et al. Risk factors associated with aortic remodeling in patients with Stanford type B aortic dissection after thoracic endovascular aortic repair. Genetics & Molecular Research. 14(4):11692-9, 2015 Oct 02. |
Observational-Dx |
54 patients |
To determine the risk factors associated with adverse aortic remodeling after thoracic endovascular aortic repair (TEVAR) in patients with Stanford type B aortic dissection. |
Multiple-logistic regression analyses were performed to identify risk factors associated with aortic remodeling. True-lumen and false-lumen volumes were increased (P < 0.001) and decreased (P < 0.001) after surgery, respectively. Therefore, the remodeling index increased after surgery (1.04 ± 0.6 to 2.06 ± 1.12, P < 0.001). Remodeling index and true-lumen volume were higher in the favorable aortic remodeling group compared to the adverse aortic remodeling group (P < 0.001), while the false-lumen volume was lower in the favorable aortic remodeling group (P < 0.001). Multivariate analyses revealed a branch originating from the false lumen (OR = 39.9, P < 0.01) and multiple tears (OR = 27.4, P < 0.01) to be independent risk factors for adverse aortic remodeling. |
4 |
| 77. Sun W, Xu H, Xiong J, et al. 3D Morphologic Findings Before and After Thoracic Endovascular Aortic Repair for Type B Aortic Dissection. Annals of Vascular Surgery. 74:220-228, 2021 Jul. |
Observational-Dx |
41 TBAD patients underwent TEVAR and CT-angiography before/after intervention (12 patients in the Enlarged Group; 29 patients in the Stable Group) |
To classify the different remodeling effects of TBAD patients after TEVAR using 3-dimensional measurement of aortic morphological changes. To hypothesize that not only initial morphological features, but also their change over time at follow-up are associated with the remodeling. |
In the Enlarged group, the number of all tears before TEVAR was significantly higher (P = 0.022), and the size of all tears at the first and second follow-up post-TEVAR were significantly higher than that in the Stable group (P = 0.008 and P = 0.007). The location of the primary tear was significantly higher (P = 0.031) in the Stable group. The cross-sectional analysis of several slices below the primary tear before TEVAR shows different shape features of the false lumen in the Stable (cone-like) and Enlarged (hourglass-like) groups. The number of tears before TEVAR has a positive correlation with the post-TEVAR development of dissection (r = 0.683, P = 0.00). |
3 |
| 78. Reutersberg B, Trenner M, Haller B, Geisbusch S, Reeps C, Eckstein HH. The incidence of delayed complications in acute type B aortic dissections is underestimated. Journal of Vascular Surgery. 68(2):356-363, 2018 08. |
Observational-Dx |
86 patients with acute TBAD |
To analyze a consecutive single-center cohort of patients who were treated for acute TBAD within the last 12.5 years |
Of all TBADs, 22 (26%) presented with immediate complications (rupture, n = 11); 64 patients (74%) were initially assessed as having uncomplicated TBAD. Of these 64 patients, 24 (28% of all 86) suffered from delayed complications (malperfusion, n = 10; aortic rupture, n = 3; early expansion >4 mm, n = 8; refractory pain, n = 2; uncontrollable hypertension, n = 1) at a median interval of 7.1 (2-14) days after symptom onset. During the first 14 days, 40 patients (46%) remained uncomplicated. The CTA analysis revealed a significant association of initial thoracic aortic diameter (P = .009), size of the primary entry tear (P = .018), true lumen collapse (P = .019), and partially thrombosed FL (P = .019) with the occurrence of delayed complications within the first 14 days. Of the patients with delayed complications, 87.5% underwent surgery (90% thoracic endovascular aortic repair, 10% peripheral revascularization); 12.5% in this group died following aortic rupture before they received surgical repair. The mortality of patients with delayed complicated TBAD was significantly higher compared with those who remained uncomplicated within the 14-day period (12.5% vs 0%; P = .0221). |
4 |
| 79. Bley TA, Chase PJ, Reeder SB, et al. Endovascular abdominal aortic aneurysm repair: nonenhanced volumetric CT for follow-up. Radiology. 2009;253(1):253-262. |
Observational-Dx |
70 patients |
To retrospectively evaluate the clinical usefulness of volumetric analysis at nonenhanced CT as the sole method with which to follow-up EVAR and to identify endoleaks causing more than 2% volumetric increase from the previous volume determination. |
Types I and III high-pressure endoleaks (n=10) showed a 10.0% (95% CI: 5.0%, 18.2%) interval volumetric increase. Type II low-pressure endoleaks (n=37) showed a 5.4% (95% CI: 4.6%, 6.2%) interval volumetric increase. Endoleaks associated with minimal aortic volume increase of less than 2% did not require any intervention. This protocol reduced radiation exposure by approximately 57%-82% in an average-sized patient. Serial volumetric analysis of aortic aneurysm with nonenhanced CT serves as an adequate screening test for endoleak, causing volumetric increase of more than 2% from the volume seen at the previous examination. |
3 |
| 80. Valente T, Rossi G, Rea G, et al. Multidetector CT findings of complications of surgical and endovascular treatment of aortic aneurysms. [Review]. Radiologic Clinics of North America. 52(5):961-89, 2014 Sep. |
Review/Other-Dx |
N/A |
To describe normal and abnormal postoperative and post-TEVAR/EVAR MDCT findings. |
No results in abstract. |
4 |
| 81. Murphy EH, Szeto WY, Herdrich BJ, et al. The management of endograft infections following endovascular thoracic and abdominal aneurysm repair. J Vasc Surg 2013;58:1179-85. |
Observational-Tx |
18 patients |
To examine the results of treatment at a single center for the management of infected aortic endografts. |
Overall, 18 patients were treated for infected endografts (thoracic: six, abdominal:12). Three patients were treated between 2000 and 2006, corresponding to a 0.6% institutional incidence of endograft infection (3/473). There were no transfers for infected endografts from outside institutions. From 2006 to 2011, 15 patients underwent treatment. Six were institutional cases of infections (6/945, 0.6% infection rate), however, there was an increase in transfers (n = 9). Median time to presentation with infection from endograft implant was 90 days, with over one-half (61%) presenting within the first 3 months. Tissue and/or blood cultures were positive in 12/16 growing Escherichia coli (n = 1), group A streptococcus (n = 3), methicillin-resistant Staphylococcus aureus (n = 3), or polymicrobial infections (n = 7). The other four patients were culture negative with computed tomography evidence of gas surrounding the endograft and clinical sepsis. Ten patients (abdominal: eight, thoracic: two) were treated with endograft explantation. The remaining eight patients were considered too high-risk for explant or refused open surgery and were therefore managed conservatively without explant (abdominal: four, thoracic: four). At a mean follow-up of 24.7 months, aneurysm-related mortality was 38.9% (n = 7) and was higher for patients presenting with aortoenteric or aortobronchial fistulas (n = 6/10, 60%) (P = .04) and for thoracic stent infections (n = 5/6; 83%) (P = .03). The only survivor of a thoracic infection was managed surgically. Overall survival for patients with abdominal endografts (n = 12) was similar between the eight patients managed surgically (n = 6/8; 75%) and the four selected for medical management (n = 4/4; 100%) (P = .39). All survivors remain on long-term suppressive antibiotics. Two additional patients died of unrelated causes during follow-up. |
2 |
| 82. Piffaretti G, Ottavi P, Lomazzi C, et al. Thoracic Endovascular Aortic Repair for Type B Acute Aortic Dissection Complicated by Descending Thoracic Aneurysm. European Journal of Vascular & Endovascular Surgery. 53(6):793-801, 2017 Jun. |
Observational-Dx |
22 patients
|
To analyse the results and review the literature about thoracic aortic endovascular repair (TEVAR) for type B acute aortic dissection (TBAAD) complicated by descending thoracic aortic aneurysm (DTA) in the hyperacute or acute phases. |
Twenty-two patients were included in the analysis. The mean aortic diameter was 66 ± 26 mm (range 42-130; IQR 51-64). The in hospital TEVAR related mortality was 14% (n = 3). The mean radiological follow-up was 56 ± 45 months (range 6-149; IQR 12-82), and the follow-up index 0.97 ± 0.1. All surviving patients were available for follow-up. During follow-up the cumulative mortality was 26% (n = 5) and TEVAR related mortality was 5% (n = 1). Overall the estimate of survival was 82% (95%CI: 61.5-93) at 1 year, and 64% at 5 years. Ongoing primary clinical success was 79% (re-intervention n = 4). Freedom from aortic related mortality was 86% (95%CI: 66-95) at 1 and 5 year, while freedom from re-intervention was 95% (95%CI: 75.5-95) at 1 year, and 77% (95%CI: 50-92) at 5 years. |
3 |
| 83. Flors L, Leiva-Salinas C, Norton PT, Patrie JT, Hagspiel KD. Endoleak detection after endovascular repair of thoracic aortic aneurysm using dual-source dual-energy CT: suitable scanning protocols and potential radiation dose reduction. AJR Am J Roentgenol. 200(2):451-60, 2013 Feb. |
Observational-Dx |
48 patients |
To evaluate the diagnostic performance of dual-source dual-energy CT (DECT) in the detection of endoleaks after thoracic endovascular aortic repair for thoracic aortic aneurysm and to investigate if a double-phase (arterial and dual-energy late delayed phase) or a single-phase (dual-energy late delayed phase) acquisition can replace the standard triphasic protocol. |
Forty-eight patients (mean age, 66 years; age range, 19-84 years) underwent 74 triple-phase CT examinations. The single-phase studies (session B) were characterized by 85.7% sensitivity, 100% specificity, 100% negative predictive value (NPV), and 94.6% positive predictive value (PPV). The dual-phase study (session C) revealed 100% sensitivity, 100% specificity, 100% NPV, and 100% PPV. The use of the dual-phase protocol and single-phase protocol resulted in a radiation exposure reduction of 19.5% and 64.1%, respectively. |
3 |
| 84. Lavingia KS, Ahanchi SS, Redlinger RE, Udgiri NR, Panneton JM. Aortic remodeling after thoracic endovascular aortic repair for intramural hematoma. Journal of Vascular Surgery. 60(4):929-35; discussion 935-6, 2014 Oct. |
Observational-Dx |
44 patients underwent TEVAR for intramural hematoma (IMH) |
To investigate the extent of aortic remodeling after thoracic endovascular aortic repair (TEVAR). |
During the 6-year period, 44 patients underwent TEVAR for IMH. Twenty-five patients had an IMH with concomitant PAU. There were 25 (57%) female patients. Mean age was 71 ± 11 years, and 40 (91%) patients had hypertension. Operative indications included intractable pain in 31 (70%), rapidly progressing IMH or conversion to dissection in 13 (30%), rupture in 10 (23%), and uncontrolled hypertension in 6 (14%). Technically successful TEVAR was performed in all patients with 42 (95%) reporting complete relief of symptoms. The 30-day mortality rate was 5% with a 5% rate of permanent paraplegia or paraparesis. At a mean follow-up of 26 months, there were no additional aortic-related deaths and overall survival was 80% with a reintervention rate of 11%. For our imaging analysis, 10 patients were excluded because of lack of follow-up imaging beyond 30 days. At a mean follow-up of 13 months, all measured data points were statistically improved from before to after TEVAR: thickness of IMH (12 mm vs. 4 mm; P = .01), mean TLD (35 mm vs. 37 mm; P = .04), mean TAD (47 mm vs 42 mm; P = .02), TAD/TLD ratio (1.35 vs. 1.14; P < .01), and IMH volume (103 cm3 vs. 14 cm3; P < .01). The mean ? in TAD/TLD ratio from before to after TEVAR for the reintervention group was ?0.14, and the mean ? in TAD/TLD ratio for the nonreintervention group was ?0.29 (P = .05). Analysis of patients with isolated IMH and those with concomitant PAU revealed no statistical differences. |
3 |
| 85. Sueyoshi E, Nagayama H, Hashizume K, Eishi K, Sakamoto I, Uetani M. Computed tomography evaluation of aortic remodeling after endovascular treatment for complicated ulcer-like projection in patients with type B aortic intramural hematoma. J Vasc Surg. 59(3):693-9, 2014 Mar. |
Observational-Tx |
18 patients |
To investigate changes of the affected aorta after endovascular treatment for complicated ulcer-like projection (ULP), including aneurysmal change or rupture of ULP, or both, in patients with type B aortic intramural hematoma (IMH). |
A stent graft was successfully deployed and ULPs disappeared in all patients. IMH disappeared in 16 or decreased in two after treatment. There were significant differences in the mean maximum aortic diameter (37.8 +/- 5.2 vs 34.5 +/- 5.2 mm; P = .0006), mean IMH volume (39.4 +/- 12.1 vs 2.0 +/- 6.0 mL; P < .0001), and total volume of the aorta with IMH (158.1 +/- 40.2 vs 128.9 +/- 28.0 mL; P < .0001) before and after treatment. |
2 |
| 86. Hughes GC, Ganapathi AM, Keenan JE, et al. Thoracic endovascular aortic repair for chronic DeBakey IIIb aortic dissection. Ann Thorac Surg 2014;98:2092-7; discussion 98. |
Review/Other-Tx |
32 patients |
To examine long-term results of TEVAR for this disorder including examination of anatomic features associated with TEVAR outcomes. |
The mean interval from dissection to TEVAR was 32 +/- 44 months (range, 1 to 146 months). There were no 30-day or in-hospital deaths, strokes, or paraplegia. During a 54-month median follow-up, there were no aortic-related deaths. Significant thoracic aneurysm sac regression (>1 cm) in the intervened segment was observed in 89%. Thoracic remodeling was not correlated with the number of visceral vessels arising from the true lumen or the number or size of residual distal fenestrations; failure of thoracic remodeling was associated with fenestrations distal to the endograft(s) in the descending thoracic aorta, most often stent graft-induced new entry tears. Complete resolution of the thoracic and abdominal false lumen after TEVAR was observed in 15.6% (n = 5). All patients in this group had all visceral vessels arising from the true lumen and fewer than three residual distal fenestrations. |
4 |
| 87. Rylski B, Hahn N, Beyersdorf F, et al. Fate of the dissected aortic arch after ascending replacement in type A aortic dissection . European Journal of Cardio-Thoracic Surgery. 51(6):1127-1134, 2017 Jun 01. |
Observational-Dx |
271 patients operated for acute type A dissection |
To evaluate the fate of a dissected aortic arch after limited surgical repair of type A aortic dissection. |
The largest increase in the total aortic diameter at follow-up was 20 mm distal to the left subclavian artery (median +4.0 mm; first quartile +1.5, third quartile +9.2 mm; P = 0.004), with an average growth rate of 1.5 mm/year (first quartile 0.6, third quartile 3.9 mm). The true lumen diameter was unchanged at follow-up. At least 1 communication between the true and the false lumina was observed in 80% of patients on the predischarge CT scan, and 70% had communications at the distal aorta-graft anastomosis. Accelerated increase in the diameter of the dissected aorta was associated with the number of communications between the lumina, communication at the distal anastomosis and false lumen perfusion (all, P < 0.001). |
3 |
| 88. Ma T, Dong ZH, Fu WG, et al. Incidence and risk factors for retrograde type A dissection and stent graft-induced new entry after thoracic endovascular aortic repair. Journal of Vascular Surgery. 67(4):1026-1033.e2, 2018 04. |
Observational-Tx |
997 patients who underwent TEVAR for TBAD (531 patients in the PBS Group; 321 patients in the Non-PBS Group) |
To investigate the incidence and risk factors for the development of retrograde type A dissection (RTAD )and stent graft (SG)-induced new entry (SINE) after thoracic endovascular aortic repair (TEVAR) for Stanford type B aortic dissection (TBAD) and to identify the complications associated with this. |
There was no significant difference between PBS and non-PBS groups in the incidence of RTAD. A greater oversizing ratio was related to a higher distal SINE rate. SINE was seen more frequently in smokers and in patients with hypertension, Marfan syndrome, and TEVAR in the chronic phase and less frequently in complicated dissection cases. Device-related factors for SINE were SG with a connecting bar and SG length <165 mm. The SG length <165 mm increased the overall proximal and distal SINE incidence in multivariate analysis. |
2 |
| 89. Klemm T, Duda S, Machann J, et al. MR imaging in the presence of vascular stents: A systematic assessment of artifacts for various stent orientations, sequence types, and field strengths. J Magn Reson Imaging. 2000; 12(4):606-615. |
Review/Other-Dx |
8 different stent types |
A systematic evaluation of the potential quality of MRI recorded in the presence of metallic stents. |
The optimal strategy for visualization of vascular and perivascular regions outside the stents was fast spin-echo imaging with the stent axis and read direction parallel to the static field. Susceptibility-induced signal void in gradient-echo images was minimal using the three-dimensional approach. Increased transmitter amplitudes above usual values provided clearly improved insight in the lumen using gradient-echo sequences. |
4 |
| 90. Shellock FG, Shellock VJ. Metallic stents: evaluation of MR imaging safety. AJR Am J Roentgenol 1999;173:543-7. |
Review/Other-Dx |
10 stents |
To evaluate safety during MR imaging (i.e., magnetic field interactions, heating, and artifacts) for metallic stents. |
For the 10 different stents evaluated, we found no magnetic field interactions. the highest temperature change was < or = +0.3 degrees C, and the artifacts involved signal voids that would not create diagnostic problems as long as the area of interest was not positioned exactly where a particular stent was located. |
4 |
| 91. Weigel S, Tombach B, Maintz D, et al. Thoracic aortic stent graft: comparison of contrast-enhanced MR angiography and CT angiography in the follow-up: initial results. Eur Radiol. 13(7):1628-34, 2003 Jul. |
Observational-Dx |
11 patients |
To compare contrast-enhanced magnetic resonance angiography (CE MRA) and multislice computed tomographic angiography (MS CTA) in the follow-up of thoracic stent-graft placement. |
The CE MRA and MS CTA were performed following nitinol stent-graft treatment due to thoracic aneurysm ( n=4), intramural bleeding ( n=2) and type-B aortic dissection ( n=5). Corresponding evaluation of arterial-phase imaging characteristics focused on the stent-graft morphology and leakage assessment. Stent-graft and aneurysm extensions were comparable between both techniques. Complete exclusion (aneurysm, n=4; dissection, n=2) was assessed with high confidence with CE MRA and MS CTA. Incomplete exclusion (intramural bleeding, n=2; dissection, n=3) was assigned to lower confidence scores on CE MRA compared with MS CTA. On CE MRA the stent-graft lumen demonstrated an inhomogeneous signal, the stent struts could not be assessed. |
3 |
| 92. Rasche V, Oberhuber A, Trumpp S, et al. MRI assessment of thoracic stent grafts after emergency implantation in multi trauma patients: a feasibility study. Eur Radiol. 21(7):1397-405, 2011 Jul. |
Observational-Dx |
20 patients |
To evaluate the feasibility of MRI for static and dynamic assessment of the deployment of thoracic aortic stent grafts after emergency implantation in trauma patients. |
The stent graft geometry and motion over the cardiac cycle were assessable by MRI in all patients. Flow-mediated signal variations in areas of flow acceleration could be well visualised. No statistically significant differences in stent-graft diameters were observed between CT and MRI measurements. |
3 |
| 93. Resta EC, Secchi F, Giardino A, et al. Non-contrast MR imaging for detecting endoleak after abdominal endovascular aortic repair. Int J Cardiovasc Imaging. 29(1):229-35, 2013 Jan. |
Observational-Dx |
23 Patients |
To investigate the possibility of ruling out endoleak after endovascular aortic repair (EVAR) of abdominal aortic aneurysm (AAA) using non-contrast MRI. |
Out of 23 patients, 13 (57%) were negative for endoleak at final assessment, while the remaining 10 (43%) were positive, with the following type distribution: Ia (n = 4), Ib (n = 2), II (n = 3), and III (n = 1). Sensitivity was 10/10 (100%; CI 95% 69-100%), specificity 7/13 (54%; 25-81%), accuracy 17/23 (74%; 52-90%), PPV 10/16 (63%; 35-85%) and NPV 7/7 (100%; 59-100%) for R1; 9/10 (90%; 56-100%), 8/13 (62%; 32-86%), 17/23 (74%; 52-90%), 9/14 (64%; 35-8%), and 8/9 (89%; 52-100%) for R2, respectively. Inter-reader Cohen kappa was 0.810. |
3 |
| 94. Lyons OT, Baguneid M, Barwick TD, et al. Diagnosis of Aortic Graft Infection: A Case Definition by the Management of Aortic Graft Infection Collaboration (MAGIC). [Review]. European Journal of Vascular & Endovascular Surgery. 52(6):758-763, 2016 Dec. |
Review/Other-Dx |
N/A |
To define precise criteria for diagnosing aortic graft infection (AGI). |
Diagnostic criteria from three categories were classified as major or minor. It is proposed that AGI should be suspected if a single major criterion or two or more minor criteria from different categories are present. AGI is diagnosed if there is one major plus any criterion (major or minor) from another category. (i) Clinical/surgical major criteria comprise intraoperative identification of pus around a graft and situations where direct communication between the prosthesis and a nonsterile site exists, including fistulae, exposed grafts in open wounds, and deployment of an endovascular stent-graft into an infected field (e.g., mycotic aneurysm); minor criteria are localized AGI features or fever =38°C, where AGI is the most likely cause. (ii) Radiological major criteria comprise increasing perigraft gas volume on serial computed tomography (CT) imaging or perigraft gas or fluid (=7 weeks and =3 months, respectively) postimplantation; minor criteria include other CT features or evidence from alternative imaging techniques. (iii) Laboratory major criteria comprise isolation of microorganisms from percutaneous aspirates of perigraft fluid, explanted grafts, and other intraoperative specimens; minor criteria are positive blood cultures or elevated inflammatory indices with no alternative source. |
4 |
| 95. Tsai MT, Wu HY, Roan JN, et al. Effect of false lumen partial thrombosis on repaired acute type A aortic dissection. Journal of Thoracic & Cardiovascular Surgery. 148(5):2140-2146.e3, 2014 Nov.J Thorac Cardiovasc Surg. 148(5):2140-2146.e3, 2014 Nov. |
Observational-Tx |
67 patients |
To investigate the effects of a partially thrombosed false lumen on the segmental growth rates, distal aortic reoperations, and long-term survival. |
The segmental aortic growth rate of completely thrombosed, completely patent, and partially thrombosed false lumens was -0.10+/-0.31, 0.09+/-0.22, and 0.35+/-0.60 mm/mo at the proximal DTA (P=.001), -0.04+/-0.18, 0.12+/-0.19, and 0.28+/-0.28 mm/mo at the middle DTA (P<.001), and -0.02+/-0.13, 0.07+/-0.07, and 0.16+/-0.14 mm/mo at the distal DTA (P<.001), respectively. The corresponding freedom from reoperation rates for the proximal DTA at 10 years were 100%, 88%, and 62% (P=.013). The overall 10-year survival rate was 89% and was not significantly different among the study groups. |
2 |
| 96. Leontyev S, Haag F, Davierwala PM, et al. Postoperative Changes in the Distal Residual Aorta after Surgery for Acute Type A Aortic Dissection: Impact of False Lumen Patency and Size of Descending Aorta. Thoracic & Cardiovascular Surgeon. 65(2):90-98, 2017 Mar. |
Observational-Dx |
105 patients with postoperative and follow-up computed tomography (CT) scans of the descending aorta |
To retrospectively identify and analyze the factors that influenced progressive dilatation of the residual distal aorta after surgical repair for acute type A aortic dissection (acute type A). |
The mean follow-up time was 4.5 ± 3 years, and the mean time interval between CT scan investigations was 2.0 ± 2.3 years. A residual dissection membrane was observed in 80 (76%) patients, with presence of a patent false lumen (FL) in 52 patients (50%) and a thrombosed FL in 28 patients (26%).Progression of aortic disease with an increase in aortic diameter greater than 10 mm was observed in 14.3% (n = 15) of patients during follow-up. The independent predictors that influenced progressive dilation of the descending aorta by 10 mm or more were postoperative descending aortic diameter greater than 40 mm (p = 0.006; odds ratio [OR], 5.6; 95% confidence interval [CI], 1.6-19) and postoperative patent FL (p = 0.002; OR, 8.5; 95% CI, 2.2-32.3).The unadjusted 1- and 5-year freedom from reoperation was 96.9 ± 2 and 80.1 ± 5%, respectively. Marfan syndrome (p = 0.006; OR, 5.2; 95% CI, 1.6-16.9) and postoperative descending aortic diameter greater than 40 mm (p = 0.07; OR, 4.1; 95% CI, 1.4-11.6) were independent predictors of aorta-related reoperations.The mean survival at 1, 5, and 8 years was 90.7 ± 3, 82.5 ± 4, and 70 ± 6%, respectively. Previous cardiac surgery was independent predictor of midterm survival (hazard ratio, 3.6; 95% CI, 1.03-2.8; p = 0.04). |
2 |
| 97. Goldstein SA, Evangelista A, Abbara S, et al. Multimodality imaging of diseases of the thoracic aorta in adults: from the American Society of Echocardiography and the European Association of Cardiovascular Imaging: endorsed by the Society of Cardiovascular Computed Tomography and Society for Cardiovascular Magnetic Resonance. [Review]. J Am Soc Echocardiogr. 28(2):119-82, 2015 Feb. |
Review/Other-Dx |
N/A |
To summarize the fundamental role of the major noninvasive imaging techniques and the clinical acumen and suspicion, knowledge of imaging modalities for the assessment and management of the often life threatening diseases of the aorta. |
No results in abstract |
4 |
| 98. Sieren MM, Schultz V, Fujita B, et al. 4D flow CMR analysis comparing patients with anatomically shaped aortic sinus prostheses, tube prostheses and healthy subjects introducing the wall shear stress gradient: a case control study. J Cardiovasc Magn Reson. 22(1):59, 2020 08 10. |
Observational-Dx |
12 patients with anatomically pre-shaped sinus prostheses (SP), 8 patients with conventional straight tube prostheses (TP), 12 healthy controls |
To compare quantitative parameters derived from 4D Flow CMR with focus on the newly introduced aortic wall shear stress (WSS) gradient in patients after implantation of anatomically pre-shaped sinus prostheses (SP) to patients who received conventional conventional straight tube prostheses (TP) and to age-matched, healthy subjects. |
In the planes bordering the prosthesis all WSS values were significantly lower in the SP compared to the TP, approaching the physiological optimum of the healthy subjects. The WSS gradient showed significantly different values in the four proximally localized contours when comparing both prostheses with healthy subjects. Strong correlations between an elevated WSS gradient and secondary flow patterns were found in the ascending aorta and the aortic arch. |
3 |
| 99. Fotaki A, Munoz C, Emanuel Y, et al. Efficient non-contrast enhanced 3D Cartesian cardiovascular magnetic resonance angiography of the thoracic aorta in 3 min. Journal of Cardiovascular Magnetic Resonance. 24(1):5, 2022 01 10. |
Observational-Dx |
35 patients with thoracic aortic disease |
To integrate undersampled acquisition with image-based navigators and inline non-rigid motion correction to enable a free-breathing, contrast-free Cartesian cardiovascular magnetic resonance angiography (CMRA) framework for the visualization of the thoracic aorta in a short and predictable scan of 3 min. |
The scan time for the iNAV-based approach was significantly shorter (3.1 ± 0.5 min vs. 12.0 ± 3.0 min for dNAV, P = 0.005). Reconstruction was performed inline in 3.0 ± 0.3 min. Diagnostic confidence was similar for the proposed iNAV versus dNAV for all three reviewers (Reviewer 1: 3.9 ± 0.3 vs. 3.8 ± 0.4, P = 0.7; Reviewer 2: 4.0 ± 0.2 vs. 3.9 ± 0.3, P = 0.4; Reviewer 3: 3.8 ± 0.4 vs. 3.7 ± 0.6, P = 0.3). The proposed method yielded higher image quality scores in terms of artefacts from respiratory motion, and non-diagnostic images due to signal inhomogeneity were observed less frequently. While the dNAV approach outperformed the iNAV method in the CR assessment, the iNAV sequence showed improved signal homogeneity along the entire thoracic aorta [RSD SI 5.1 (4.4, 6.5) vs. 6.5 (4.6, 8.6), P = 0.002]. BAA showed a mean difference of < 0.05 cm across the 6 landmarks between the two datasets. ICC showed excellent inter- and intra-observer reproducibility. |
1 |
| 100. National Academies of Sciences, Engineering, and Medicine; Division of Behavioral and Social Sciences and Education; Committee on National Statistics; Committee on Measuring Sex, Gender Identity, and Sexual Orientation. Measuring Sex, Gender Identity, and Sexual Orientation. In: Becker T, Chin M, Bates N, eds. Measuring Sex, Gender Identity, and Sexual Orientation. Washington (DC): National Academies Press (US) Copyright 2022 by the National Academy of Sciences. All rights reserved.; 2022. |
Review/Other-Dx |
N/A |
Sex and gender are often conflated under the assumptions that they are mutually determined and do not differ from each other; however, the growing visibility of transgender and intersex populations, as well as efforts to improve the measurement of sex and gender across many scientific fields, has demonstrated the need to reconsider how sex, gender, and the relationship between them are conceptualized. |
No abstract available. |
4 |
| 101. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://www.acr.org/-/media/ACR/Files/Appropriateness-Criteria/RadiationDoseAssessmentIntro.pdf. |
Review/Other-Dx |
N/A |
To provide evidence-based guidelines on exposure of patients to ionizing radiation. |
No abstract available. |
4 |
