| 1. Bonci G, Steigner ML, Hanley M, et al. ACR Appropriateness Criteria R Thoracic Aorta Interventional Planning and Follow-Up. Journal of the American College of Radiology. 14(11S):S570-S583, 2017 Nov. |
Review/Other-Dx |
N/A |
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for thoracic aorta interventional planning and follow-up. |
No results stated in abstract. |
4 |
| 2. Francois CJ, Skulborstad EP, Majdalany BS, et al. ACR Appropriateness Criteria® Abdominal Aortic Aneurysm: Interventional Planning and Follow-Up. J Am Coll Radiol 2018;15:S2-S12. |
Review/Other-Dx |
N/A |
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for abdominal Aortic aneurysm: interventional planning and follow-up. |
No results stated in abstract. |
4 |
| 3. Coselli JS, LeMaire SA, Preventza O, et al. Outcomes of 3309 thoracoabdominal aortic aneurysm repairs. Journal of Thoracic & Cardiovascular Surgery. 151(5):1323-37, 2016 May. |
Observational-Tx |
2043 patients |
To describe our approximately 3-decade single-practice experience regarding 3309 thoracoabdominal aortic aneurysm repairs and identify predictors of early death and other adverse postoperative outcomes. |
There were 249 operative deaths (7.5%). Permanent paraplegia and paraparesis occurred after 97 (2.9%) and 81 (2.4%) repairs, respectively. Of 189 patients (5.7%) with permanent renal failure, 107 died in the hospital. Permanent stroke was relatively uncommon (n = 74; 2.2%). The rate of the composite adverse event (n = 478; 14.4%) was highest after extent II repair (n = 203; 19.0%) and lowest after extent IV repair (n = 67; 10.2%; P < .0001). Estimated postoperative survival was 83.5% ± 0.7% at 1 year, 63.6% ± 0.9% at 5 years, 36.8% ± 1.0% at 10 years, and 18.3% ± 0.9% at 15 years. |
2 |
| 4. Kang PC, Bartek MA, Shalhub S, Nathan DP, Sweet MP. Survival and patient-centered outcome in a disease-based observational cohort study of patients with thoracoabdominal aortic aneurysm. J Vasc Surg. 70(5):1427-1435, 2019 11. |
Observational-Tx |
432 patients |
To describe two primary endpoints: (1) survival at one year in all patients presenting with TAAA to a regional referral center including both operative and nonoperative patients, and (2) a patient-centered “good” outcome, which includes return to preoperative functional status for all patients receiving an operative intervention by all modalities performed at our institution. |
After review of CT imaging, 432 of 718 patients initially identified by ICD codes met inclusion criteria. Advanced medical comorbidities were seen in 33% of the entire cohort. Nonoperative management was utilized for 48% of the cohort with a 1-year survival of 65%. A survival benefit was seen in the open, endovascular and partial but not hybrid operative groups over the nonoperative group over a three-year period. Overall 1-year survival was 81%, but only 68% had a “good” outcome (p=0.0016). |
2 |
| 5. Ockert S, Riemensperger M, von Tengg-Kobligk H, Schumacher H, Eckstein HH, Bockler D. Complex abdominal aortic pathologies: operative and midterm results after pararenal aortic aneurysm and type IV thoracoabdominal aneurysm repair. Vascular. 17(3):121-8, 2009 May-Jun. |
Review/Other-Tx |
63 patients |
To describe the clinical outcome of pararenal aortic aneurysm (PAAA) and type IV thoracoabdominal aneurysm (TAAA) repair, with special consideration placed on disease-related complications and midterm follow-up. |
During the study period, 63 patients (33 PAAAs, 30 type IV TAAAs) underwent aortic repair. The 30-day mortality rate of 7.9% was acceptable for complex aortic entities compared with other series. The morbidity for cardiac events was 3.2%, for pulmonary complications 17.5%, and the need for reoperation was 14.3%. With regard to disease-related complications, two patients (3.2%) required dialysis and one patient (1.6%) developed paraplegia (spinal cord ischemia) after type IV TAAA repair. |
4 |
| 6. Bianchini Massoni C, Geisbusch P, Gallitto E, Hakimi M, Gargiulo M, Bockler D. Follow-up outcomes of hybrid procedures for thoracoabdominal aortic pathologies with special focus on graft patency and late mortality. J Vasc Surg. 59(5):1265-73, 2014 May. |
Observational-Tx |
45 patients |
To analyze midterm results of bypass patency and overall and aortic-related mortality rates of hybrid aortic procedures for thoracoabdominal aortic pathologies. |
Technical success was achieved in 86.6% (39/45) of patients. Thirty-day morbidity rate was 60% (paraplegia/paraparesis: 13.3%, stroke: 6.7%, renal failure: 31.3%, permanent dialysis: 4.4%). Thirty-day freedom from reintervention rates were 67.1% and 78.5%, respectively. Thirty-day occlusion of revascularized visceral vessels occurred in 11 (7.1%, 11/155) target arteries. In-hospital mortality rate was 24.4%. Primary graft patency after 1, 2, and 4 years was 89.7%, 85.3%, and 79%, respectively. Bypass thrombosis or stenosis developed in nine (6.8%, 9/132) vessels during follow-up. Of these, three patients required reintervention and one died. Freedom from reintervention rates after 1, 2, and 4 years were 45.6%, 45.6%, and 34.2%, respectively. Overall and aortic-related mortality rates after 1, 2, and 4 years were 32.6%, 41.4%, and 45.3% and 9.1%, 13.9%, and 13.9%, respectively. |
2 |
| 7. Hughes GC, Barfield ME, Shah AA, et al. Staged total abdominal debranching and thoracic endovascular aortic repair for thoracoabdominal aneurysm. J Vasc Surg. 56(3):621-9, 2012 Sep. |
Observational-Tx |
47 patients |
To describe the largest single-institution series to date of total visceral debranching and endovascular repair for TAAAs and the techniques we have developed to perform this operation. |
Median patient age was 71.0 ± 9.8 years. All had significant comorbidity and were considered suboptimal candidates for conventional repair: 55% had undergone previous aortic surgery, 40% were American Society of Anesthesiologists (ASA) class 4, and baseline serum creatinine was 1.5 ± 1.3 mg/dL. The 30-day/in-hospital rates of death, stroke, and permanent paraparesis/plegia were 8.5%, 0%, and 4.3%, respectively, but 0% in the most recent 14 patients undergoing staged repair. These patients had significantly shorter combined operative times (314 vs 373 minutes), decreased intraoperative red blood cell transfusions (350 vs 1400 mL), and were more likely to be extubated in the operating room (50% vs 12%) compared with patients undergoing simultaneous repair. Over a median follow-up of 19.3 ± 18.5 months, visceral graft patency was 97%; all occluded limbs were to renal vessels and clinically silent. There have been no type I or III endoleaks or reinterventions. Kaplan-Meier overall survival is 70.7% at 2 years and 57.9% at 5 years. |
2 |
| 8. Markatis F, Petrosyan A, Abdulamit T, Bergeron P. Hybrid repair with antegrade visceral artery debranching: the preferred treatment option for thoracoabdominal aneurysms in high-risk patients. J Endovasc Ther. 19(3):356-62, 2012 Jun. |
Observational-Tx |
9 patients |
To present a hybrid repair technique that may decrease the morbidity and mortality associated with thoracoabdominal aneurysm (TAAA) repair, especially in high-risk patients. |
There was no perioperative mortality, paraplegia, or permanent renal failure. Following the debranching procedure, there were 4 cases of transient renal dysfunction, 1 minor stroke (resolved), and 1 low-flow pancreatic fistula that regressed. There were no complications after the endovascular repair. Over a mean follow-up of 28 months (range 8-50), all patients are alive, with good patency of the bypass grafts and endografts. One late type II endoleak is under surveillance. |
4 |
| 9. Lobato AC, Camacho-Lobato L. A new technique to enhance endovascular thoracoabdominal aortic aneurysm therapy--the sandwich procedure. Semin Vasc Surg. 25(3):153-60, 2012 Sep. |
Observational-Tx |
15 patients with TAAA |
To provide a detailed stepwise, fully illustrated description of the ST for TAAA, as well as ascertain its safety and efficiency for aneurysm exclusion andtarget vessel endorevascularization for these types of aortic aneurysms. |
Technical success rate was 92.3% and, in one patient (TAAA), both renal arteries could not be cannulated by guide wire and the procedure was aborted. Total, elective, and emergency 30-day mortality rates were 20% (3/15), 7.7% (1/13), and 100% (2 of 2), respectively. Two other deaths were unrelated to the procedure and due to hemorrhagic stroke (10 months) and lymphoma (12 months). Forty-eight visceral arteries (mean 3.4 arteries/patient) were successfully endorevascularized (22 renal arteries, 14 superior mesenteric arteries and 12 celiac trunks) with self-expandable covered stents and bare stents inside it in 14 patients. Three right and two left renal arteries could not be cannulated (5 of 54), comprising 9.2% failure to treat target vessels. Primary patency rate was 97.9%, with only 1 of 48 with endorevascularized target vessel occlusion. No spinal cord ischemia events were observed during the follow-up period. Three transient renal function impairments (20%) and one type III endoleak (11%), which sealed spontaneously at the 1-month assessment, were detected. |
2 |
| 10. Oderich GS, Ribeiro M, Reis de Souza L, Hofer J, Wigham J, Cha S. Endovascular repair of thoracoabdominal aortic aneurysms using fenestrated and branched endografts. J Thorac Cardiovasc Surg. 153(2):S32-S41.e7, 2017 02. |
Observational-Tx |
185 patients with thoracoabdominal aortic aneurysms |
To review the outcomes of patients treated for thoracoabdominal aortic aneurysms using endovascular repair with fenestrated and branched stent-grafts in a single center. |
A total of 112 patients (60%) were treated for extent IV thoracoabdominal aortic aneurysms, and 73 patients (40%) were treated for extent I to III thoracoabdominal aortic aneurysms. Demographics and cardiovascular risk factors were similar in both groups. A total of 687 renal-mesenteric arteries (3.7 vessels/patient) were targeted by 540 fenestrations and 147 directional branches. Technical success was 94%. Thirty-day mortality was 4.3%, including a mortality of 1.8% for extent IV and 8.2% for extent I to III thoracoabdominal aortic aneurysms (P = .03). Mortality decreased in the second half of clinical experience from 7.5% to 1.2%, including a decrease of 3.3% to 0% for extent IV thoracoabdominal aortic aneurysms (P = .12) and 15.6% to 2.4% for extent I to III thoracoabdominal aortic aneurysms (P = .04). Early major adverse events occurred in 36 patients (32%) with extent IV thoracoabdominal aortic aneurysms and 26 patients (36%) with extent I to III thoracoabdominal aortic aneurysms, including spinal cord injury in 2 patients (1.8%) and 4 patients (3.2%), respectively. Mean follow-up was 21 ± 20 months. At 5 years, patient survival (56% and 59%, P = .37) and freedom from any reintervention (50% and 53%, P = .26) were similar in those with extent IV and extent I to III thoracoabdominal aortic aneurysms. Primary patency was 93% at 5 years. |
2 |
| 11. Schwierz E, Kolvenbach RR, Yoshida R, Yoshida W, Alpaslan A, Karmeli R. Experience with the sandwich technique in endovascular thoracoabdominal aortic aneurysm repair. J Vasc Surg. 59(6):1562-9, 2014 Jun. |
Observational-Tx |
32 patients with TAAAs |
to present midterm results with a modified procedure and a larger number of patients with thoracoabdominal aneurysms. |
During the study period, 32 patients with TAAAs were treated with sandwich grafts. Indication for the procedure in 43% was an acute onset of symptoms, including two patients with a rupture and a retroperitoneal hematoma. Three patients required an additional debranching procedure. A total of 104 chimney grafts were implanted. Two patients died postoperatively because of the operation. Major adverse events were recorded in five patients, including one patient with persistent paraplegia and two with permanent renal failure requiring dialysis. The incidence of chimney graft occlusion was higher in patients with three or four parallel grafts than in those with two chimney grafts only. Patients with chronic dissections had a 12-times higher incidence of chimney graft occlusion than aneurysm patients. The number of patients with type I or III endoleaks was higher in the group with three or four parallel grafts. |
2 |
| 12. Sweet MP, Starnes BW, Tatum B. Endovascular treatment of thoracoabdominal aortic aneurysm using physician-modified endografts. J Vasc Surg. 62(5):1160-7, 2015 Nov. |
Observational-Tx |
21 patients |
To report an initial experience with physician-modified thoracic endografts for endovascular treatment of thoracoabdominal aortic aneurysm (TAAA). |
Twenty-four consecutive patients were treated. Twenty-one patients (88%) met the endpoint of treatment success at a mean of 11 months follow-up. One patient (4%) died within 30 days due to complications of spinal cord injury (SCI). One patient (4%) died 4 months postoperatively after a prolonged recovery from surgery. One other patient (4%) is alive 13 months after operation with permanent SCI. One renal reintervention has been required. No device failures have occurred. |
4 |
| 13. Clough RE, Martin-Gonzalez T, Van Calster K, et al. Endovascular Repair of Thoracoabdominal and Arch Aneurysms in Patients with Connective Tissue Disease Using Branched and Fenestrated Devices. Ann Vasc Surg. 44:158-163, 2017 Oct. |
Observational-Tx |
427 endovascular interventions |
To evaluate mid-term outcomes of fenestrated and/or branched endografting in patients with connective tissue disease. |
In total, 427 (403 pararenal and TAAAs, and 24 arch aneurysms) endovascular interventions were performed during the study period. Of these, 17 patients (4%) (16 TAAAs, 1 arch) had connective tissue disease. All patients were classified as unfit for open repair. The mean age was 51 ± 8 years. Thirteen patients with TAAA were treated with a fenestrated, 1 with a branched, and 2 with a combined fenestrated/branch device. A double inner branch device was used to treat the arch aneurysm. The technical success rate was 100% with no incidence of early mortality, spinal cord ischemia, stroke, or further dissection. Postoperative deterioration in renal function was seen in 3 patients (18.8%) and no hemodialysis was required. The mean follow-up was 3.4 years (0.3-7.4). Aneurysm sac shrinkage was seen in 35% of patients (6/17) and the sac diameter remained stable in 65% of patients (11/17). No sac or sealing zone enlargement was observed in any of the patients and there were no conversions to open repair. Reintervention was required in 1 patient at 2 years for bilateral renal artery occlusion (successful fibrinolysis). One type II endoleak (lumbar) is under surveillance and 1 type III (left renal stent) sealed spontaneously. One patient died at 2 years after the procedure from nonaortic causes (endocarditis). |
4 |
| 14. Eagleton MJ, Follansbee M, Wolski K, Mastracci T, Kuramochi Y. Fenestrated and branched endovascular aneurysm repair outcomes for type II and III thoracoabdominal aortic aneurysms. J Vasc Surg. 63(4):930-42, 2016 Apr. |
Observational-Tx |
354 high-risk patients (1305 fenestration/branches) |
To evaluate the technical and clinical outcomes of fenestrated and branched (F/B) endografts used in endovascular aneurysm repair (EVAR) for extensive type II and III thoracoabdominal aortic aneurysm (TAAA). |
F/B-EVARs incorporating 1305 fenestration/branches were implanted with 96% of target vessels successfully stented. Completion aortography showed 2.8% patients had a type I or III endoleak. Procedure duration (6.0 ± 1.7 vs 5.5 ± 1.6 hours; P < .01) and hospital stay (13.1 ± 10.1 vs 10.2 ± 7.4 days; P < .01) were longer for type II TAAA. Perioperative mortality was greater in type II repairs (7.0% vs 3.5%; P < .001). Permanent spinal cord ischemia occurred in 4% and renal failure requiring hemodialysis occurred in 2.8% of patients. Twenty-seven branches (7.6%) required reintervention for stenosis or occlusion; and celiac artery, superior mesenteric artery, and renal artery secondary patency at 36 months was 96% (95% confidence interval [CI], 0.93-0.99), 98% (95% CI, 0.97-1.0), and 98% (95% CI, 0.96-1.0), respectively. Eighty endoleak repairs were performed in 67 patients, including 55 branch-related endoleaks, 4 type Ia, 5 type Ib, and 15 type II endoleaks. At 36 months, freedom from aneurysm-related death was 91% (95% CI, 0.88-0.95), and freedom from all-cause mortality was 57% (95% CI, 0.50-0.63). The treatment of type II TAAA (P < .01), age (P < .01), and chronic obstructive pulmonary disease (P < .05) negatively affected survival. |
1 |
| 15. Haulon S, D'Elia P, O'Brien N, et al. Endovascular repair of thoracoabdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 39(2):171-8, 2010 Feb. |
Observational-Tx |
33 consecutive patients |
To evaluate the early outcomes following thoracoabdominal aortic aneurysm (TAAA) repair utilising fenestrated and branched endografts. |
Thirty-three consecutive patients (30 males) were treated over 33 months (August 2006 to April 2009). Median age and aneurysm size were 70 years (range 50-83 years) and 64 mm (range 55-100 mm) respectively. 114/116 (98%) of the targeted visceral vessels were successfully catheterised and perfused. The in-hospital mortality rate was 9% (3/33). Transient spinal cord ischaemia was diagnosed in 4/33 (12%) patients, and permanent paraplegia in one (3%). The median follow-up period was 11 months (range 1-33 months). Endoleaks were identified in 5/33 (15%) patients: type II in four patients and a type III endoleak in one patient which required the only secondary intervention. During follow-up, two patients died: one from stroke and the other from myocardial infarction 9 and 29 months respectively after the procedure. |
2 |
| 16. Law Y, Kolbel T, Rohlffs F, et al. Safety and durability of infrarenal aorta as distal landing zone in fenestrated or branched endograft repair for thoracoabdominal aneurysm. J Vasc Surg. 69(2):334-340, 2019 02. |
Observational-Tx |
40 patients who received FB-EVAR |
To examine whether the infrarenal aorta as a distal landing zone was secure and durable over time after FB-EVAR. |
Between August 2011 and August 2017, 40 patients (40% male with a mean age of 72 ± 8 years) affected by types I (37.5%), II (25.0%), III (20.0%), and V (17.5%) thoracoabdominal aneurysms were included. The mean aneurysm diameter was 6.4 ± 1.5 cm. There was no immediate or delayed type IB endoleak with mean follow-up period of 15 ± 18 months (range, 0-72 months). Postoperative complications included six (15%) spinal cord ischemia (five temporary and one permanent) and no mesenteric ischemia. There were three deaths (7.5%) within 30 days. Follow-up with computed tomography arteriography showed that 37 patients (92.5%) had at least one lumbar artery preserved. Out of the 31 preoperatively patent IMA, 23 (74.2%) were preserved. There was one incidental finding of new focal dissection distal to the stent graft end. Mean infrarenal aorta diameters were 24.8, 27.7, 27.7, and 29.4 mm immediately preoperatively, and at 1 and 2 years postoperatively, respectively. The mean maximal right common iliac diameters were stable and measured 15.8, 15.9, and 14.8 mm preoperatively, immediately postoperatively, and 1 year postoperatively, respectively. Mean maximal left common iliac diameters were also stable and measured 15.7, 15.9, and 14.7 mm preoperatively, immediately postoperatively, and at 1 year postoperatively, respectively. |
2 |
| 17. Mell MW, Baker LC, Dalman RL, Hlatky MA. Gaps in preoperative surveillance and rupture of abdominal aortic aneurysms among Medicare beneficiaries. J Vasc Surg. 59(3):583-8, 2014 Mar. |
Observational-Tx |
9298 patients |
To investigate the frequency and predictors of rupture of previously diagnosed abdominal aortic aneurysms (AAAs). |
A total of 9298 patients had repair after early diagnosis, with rupture occurring in 441 (4.7%). Those with ruptured AAAs were older (80.2 ± 6.9 vs 77.6 ± 6.2 years; P < .001), received fewer images prior to repair (5.7 ± 4.1 vs 6.5 ± 3.5; P = .001), were less likely to be treated in a high-volume hospital (45.4% vs 59.5%; P < .001), and were more likely to have had gaps in surveillance (47.4% vs 11.8%; P < .001) compared with those receiving repair for intact AAAs. After adjusting for medical comorbidities, gaps in surveillance remained the largest predictor of rupture in a multivariate analysis (odds ratio, 5.82; 95% confidence interval, 4.64-7.31; P < .001). |
3 |
| 18. Collard M, Sutphin PD, Kalva SP, et al. ACR Appropriateness Criteria® Abdominal Aortic Aneurysm Follow-up (Without Repair). J Am Coll Radiol 2019;16:S2-S6. |
Review/Other-Dx |
N/A |
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for abdominal aortic aneurysm follow-up (without repair). |
No results stated in abstract. |
4 |
| 19. Jamalidinan F, Hassanabad AF, Francois CJ, Garcia J. Four-dimensional-flow Magnetic Resonance Imaging of the Aortic Valve and Thoracic Aorta. [Review]. Radiol Clin North Am. 58(4):753-763, 2020 Jul. |
Review/Other-Dx |
N/A |
To introduce 4D-flow MRI as it is currently used for blood flow visualization and quantification of cardiac hemodynamic parameters; To discuss its advantages relative to other flow MRI techniques and describe its potential clinical applications. |
No results provided |
4 |
| 20. Katahashi K, Sano M, Takehara Y, et al. Flow dynamics of type II endoleaks can determine sac expansion after endovascular aneurysm repair using four-dimensional flow-sensitive magnetic resonance imaging analysis. J Vasc Surg. 70(1):107-116.e1, 2019 07. |
Observational-Dx |
107 patients |
To investigate the hemodynamic parameters of type II endoleaks (T2ELs) to predict sac expansion using four-dimensional flow-sensitive magnetic resonance imaging (4D-flow MRI) analysis. |
Of 155 patients who underwent EVAR, both CT angiography and 4D-flow MRI were performed in 107 patients at 7 days after EVAR. Among them, 39 (36.4%) were found to have a T2EL, of whom 28 were re-evaluated with CT angiography and 4D-flow at 1 year; 7 patients had expanding sacs (expanding group), whereas 21 had nonexpanding sacs (not-expanding group). At 7 days, 28 patients had 80 T2EL vessels detected by 4D-flow MRI, of which 39 vessels (48.8%) had stopped flowing at 1 year (transient vessels); 41 vessels (51.3%) had sustained flow (persistent vessels). The persistent vessels had significantly larger peak flow velocity and amplitude of dynamics of blood flow. The comprehensive analysis of T2EL vessels per sac identified that the amplitude of dynamics of blood flow in the tributary arteries per sac was significantly higher in the expanding group than in the not-expanding group. A receiver operating characteristic curve analysis revealed that the sensitivity and specificity of sac enlargement at a cutoff value of 3750 mm3/min were 85.7% and 76.2%, respectively. |
2 |
| 21. Kolipaka A, Illapani VS, Kenyhercz W, et al. Quantification of abdominal aortic aneurysm stiffness using magnetic resonance elastography and its comparison to aneurysm diameter. J Vasc Surg. 64(4):966-74, 2016 Oct. |
Experimental-Dx |
36 patients |
(1) determine magnetic resonance elastography (MRE)-derived aortic wall stiffness in AAA patients and its correlation to AAA diameter; (2) determine the correlation between AAA stiffness and amount of thrombus and calcium; and (3) compare the AAA stiffness measurements against age-matched healthy individuals. |
No significant correlation (P > .1) was found between AAA stiffness and diameter or amount of thrombus or calcium score. AAA stiffness (mean 13.97 ± 4.2 kPa) is significantly (P = .02) higher than remote normal aorta in AAA (mean 8.87 ± 2.2 kPa) patients and in normal individuals (mean 7.1 ± 1.9 kPa). |
1 |
| 22. Midulla M, Moreno R, Baali A, et al. Haemodynamic imaging of thoracic stent-grafts by computational fluid dynamics (CFD): presentation of a patient-specific method combining magnetic resonance imaging and numerical simulations. Eur Radiol. 22(10):2094-102, 2012 Oct. |
Observational-Dx |
20 patients |
To present an imaging method combining magnetic resonance imaging (MRI) and computational fluid dynamics (CFD) to obtain a patient-specific haemodynamic analysis of patients treated by thoracic endovascular aortic repair (TEVAR). |
Twenty patients (14 men; mean age 62.2 years) with different aortic lesions were evaluated. Four-dimensional mapping of velocity and wall shear stress were obtained, depicting different patterns of flow (laminar, turbulent, stenosis-like) and local alterations of parietal stress in-stent and along the native aorta. |
4 |
| 23. 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 |
| 24. Suh GY, Les AS, Tenforde AS, et al. Quantification of particle residence time in abdominal aortic aneurysms using magnetic resonance imaging and computational fluid dynamics. Ann Biomed Eng. 39(2):864-83, 2011 Feb. |
Observational-Dx |
8 patients with known small AAAs |
To use magnetic resonance imaging (MRI) and computational fluid dynamics (CFD) to quantify flow stagnation and recirculation in eight abdominal aortic aneurysms (AAAs) by computing particle residence time (PRT). |
Specifically, we used gadolinium-enhanced MR angiography to obtain images of the vessel lumens, which were used to generate subject-specific models. We also used phase-contrast MRI to measure blood flow at supraceliac and infrarenal locations to prescribe physiologic boundary conditions. CFD was used to simulate pulsatile flow, and PRT, particle residence index, and particle half-life of PRT in the aneurysms were computed. We observed significant regional differences of PRT in the aneurysms with localized patterns that differed depending on aneurysm geometry and infrarenal flow. A bulbous aneurysm with the lowest mean infrarenal flow demonstrated the slowest particle clearance. In addition, improvements in particle clearance were observed with increase of mean infrarenal flow. |
4 |
| 25. Ichihashi S, Marugami N, Tanaka T, et al. Preliminary experience with superparamagnetic iron oxide-enhanced dynamic magnetic resonance imaging and comparison with contrast-enhanced computed tomography in endoleak detection after endovascular aneurysm repair. J Vasc Surg. 58(1):66-72, 2013 Jul. |
Observational-Dx |
23 patients |
To examine superparamagnetic iron oxide (SPIO)-enhanced dynamic MRI as a potential alternative to contrast-enhanced computed tomogrpahy (CE-CT) for detection of endoleaks after EVAR. |
A total of 11 type II endoleaks originating from either the lumbar or inferior mesenteric artery were detected. Eight were able to be detected by CE-CT (8/11:73%) and 10 (10/11:91%) by SPIO-enhanced MRI. Interobserver (kappa = 0.91; 95% CI, 0.74-1.00) and intraobserver agreement for MRI (kappa = 1.00) were excellent. Intermodality agreement for endoleak detection was moderate (kappa = 0.63; 95% CI, 0.32-0.94; and kappa = 0.62; 95% CI, 0.29-0.95 for observers A and B, respectively). |
1 |
| 26. Sadat U, Taviani V, Patterson AJ, et al. Ultrasmall superparamagnetic iron oxide-enhanced magnetic resonance imaging of abdominal aortic aneurysms--a feasibility study. Eur J Vasc Endovasc Surg. 41(2):167-74, 2011 Feb. |
Observational-Dx |
14 patients |
To assess whether USPIO uptake in AAAs can be quantified using both T2*- and T2- relaxation measurements. |
There was a significant difference between pre- and post-infusion T(2)* and T(2) values (both respective p-values = 0.005). A significant correlation between T(2)* and T(2) values post-USPIO infusion was observed (r = 0.90, p < 0.001), which indicates USPIO uptake by the aortic wall. |
4 |
| 27. Lichtenberger JP 3rd, Franco DF, Kim JS, Carter BW. MR Imaging of Thoracic Aortic Disease. [Review]. Top Magn Reson Imaging. 27(2):95-102, 2018 Apr. |
Review/Other-Dx |
N/A |
To discuss the role of MR imaging in the evaluation of thoracic aorta pathology along with pertinent examples of aortic abnormalities. |
No results provided |
4 |
| 28. Engellau L, Albrechtsson U, Dahlstrom N, Norgren L, Persson A, Larsson EM. Measurements before endovascular repair of abdominal aortic aneurysms. MR imaging with MRA vs. angiography and CT. Acta Radiol. 44(2):177-84, 2003 Mar. |
Observational-Dx |
20 |
1) To compare measurements obtained with MR imaging (MRI)/contrast-enhanced MR angiography (CE MRA) with measurements obtained with angiography (DSA) and CT, for stent-graft sizing of abdominal aortic aneurysms (AAA). 2) To compare MRA measurements obtained with the two post processing techniques MIP (maximum intensity projection) and VRT (3D volume rendering technique). |
Significantly shorter lengths were obtained with MRA-MIP than with DSA. Three out of six diameter measurements were significantly smaller on MRI/CE MRA than on DSA and CT. No significant differences were found between the observers. One diameter measurement was significantly smaller on MIP than on VRT, while the other measurements showed no significant differences. |
2 |
| 29. Bolen MA, Popovic ZB, Tandon N, Flamm SD, Schoenhagen P, Halliburton SS. Image quality, contrast enhancement, and radiation dose of ECG-triggered high-pitch CT versus non-ECG-triggered standard-pitch CT of the thoracoabdominal aorta. AJR Am J Roentgenol. 198(4):931-8, 2012 Apr. |
Observational-Dx |
101 patients |
To compare image quality, contrast enhancement, and radiation dose in patients undergoing ECG-triggered high-pitch helical CT or non-ECG-synchronized helical CT of the thoracoabdominal aorta. |
Image quality at the root-proximal ascending level was higher in group 1 (mean ± SD, 2.81 ± 0.40) than in group 2 (1.22 ± 0.47; p < 0.0001), with similar quality for both groups noted at other levels. Group 1 scans displayed higher image noise at all levels. The groups received a similar volume of contrast material (p = 0.77), and similar percentages of cases with acceptable contrast enhancement (> 250 HU) were noted in the two groups. The estimated radiation burden was significantly lower in group 1 (mean ± SD, 5.4 ± 1.8 mSv) than in group 2 (14.4 ± 5.1 mSv; p < 0.0001). |
2 |
| 30. Hinzpeter R, Eberhard M, Gutjahr R, et al. CT Angiography of the Aorta: Contrast Timing by Using a Fixed versus a Patient-specific Trigger Delay. Radiology. 291(2):531-538, 2019 05. |
Observational-Dx |
108 participants |
To compare contrast opacification in CT angiography of the aorta between a cohort with fixed trigger delay and a cohort with patient-specific individualized trigger delay for contrast media timing with bolus tracking. |
The fixed cohort had 108 study participants (16 women; mean age ± standard deviation, 72 years ± 10); the individualized cohort had 108 participants (16 women; mean age, 72 years ± 12). The trigger delay in the individualized cohort ranged from 6.4-11.3 seconds (mean, 9.2 seconds). There was higher overall attenuation in the individualized cohort than in the fixed cohort (486 HU ± 92 for individualized vs 438 HU ± 99 for fixed; P < .001), with increasing differences from the aortic arch (8 HU) to the iliac arteries (95 HU). The regression model indicated uniform attenuation in the individualized cohort and decreasing attenuation in the fixed cohort (decrease of 87 HU by the iliac arteries; P < .001). There was no difference between cohorts for image noise (20 vs 19; P = .41), but contrast-to-noise ratio (21 vs 19; P = .04) and subjective image quality were higher in the individualized cohort than in the fixed cohort (excellent or good image quality, 100% vs 67%; P < .001). |
1 |
| 31. Yang S, Li X, Chao B, et al. Abdominal aortic intimal flap motion characterization in acute aortic dissection: assessed with retrospective ECG-gated thoracoabdominal aorta dual-source CT angiography. PLoS ONE. 9(2):e87664, 2014. |
Observational-Dx |
49 patients who had thoracoabdominal aorta retrospective ECG-gated CTA |
To evaluate the feasibility of dose-modulated retrospective ECG-gated thoracoabdominal aorta CT angiography (CTA) assessing abdominal aortic intimal flap motion and investigate the motion characteristics of intimal flap in acute aortic dissection (AAD). |
In these 49 patients, 37 had AAD, 7 had intramural hematoma, and 5 had negative result for acute aortic disorder. 620 datasets of 31 patients who showed double lumens in abdominal aorta were enrolled in evaluating intimal flap motion. The maximum and minimum true lumen diameter were 12.2 ± 4.1 mm (range 2.6 ~ 17.4) and 6.7 ± 4.1 mm (range 0 ~ 15.3) respectively. The range of intimal flap motion in all patients was 5.5 ± 2.6 mm (range 1.8 ~ 10.2). The extent of maximum true lumen diameter decreased during a cardiac cycle was 49.5% ± 23.5% (range 12% ~ 100%). The maximum motion phase of true lumen diameter was in systolic phase (5% ~ 40% of R-R interval). Maximum and minimum intimal flap motion was at 15% and 75% of the R-R interval respectively. Intimal flap configuration had correlation with the phase of cardiac cycle. |
4 |
| 32. Bobadilla JL, Suwanabol PA, Reeder SB, Pozniak MA, Bley TA, Tefera G. Clinical implications of non-contrast-enhanced computed tomography for follow-up after endovascular abdominal aortic aneurysm repair. Ann Vasc Surg. 27(8):1042-8, 2013 Nov. |
Observational-Dx |
126 Patients |
To evaluate the use of nonecontrast-enhanced CT as the primary method of follow-up after EVAR of AAAs. |
Over a 7-year period, 126 patients were followed. Serial CTA was performed in 59 patients, while 67 patients were followed with the NCT protocol. The mean follow-up was 2.07 years. There were no differences in age, sex, or initial aneurysm volume or size. There were 35 total endoleaks identified. Twenty of these were early endoleaks (<30 days post-EVAR). The remaining 15 leaks were late in nature (10 in the contrast group and 5 in the noncontrast group; P=0.17). NCT aneurysm sac volume changes prompted contrasted studies in all 5 late leaks. The mean volume change was 11.2 cm3, an average change of 5.88%. These findings were not significantly different than the late leaks found by routine contrast studies (8.9 cm3; 4.98% [P=0.58]). There were no delayed ruptures or emergent reinterventions in the NCT group. |
3 |
| 33. 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 |
| 34. Lu TL, Rizzo E, Marques-Vidal PM, Segesser LK, Dehmeshki J, Qanadli SD. Variability of ascending aorta diameter measurements as assessed with electrocardiography-gated multidetector computerized tomography and computer assisted diagnosis software. Interact Cardiovasc Thorac Surg. 10(2):217-21, 2010 Feb. |
Observational-Dx |
30 patients |
To assess the variability in measuring diameters of the ascending aorta and to compare the intraobserver and interobserver variability of CAD vs. manual measurements. |
Thirty patients referred for ECG-gated CT thoracic angiography were evaluated. Continuous reformations of the ascending aorta, perpendicular to the centerline, were obtained automatically with a commercially available computer aided diagnosis (CAD). Then measurements of the maximal diameter were done with the CAD and manually by two observers (separately). Measurements were repeated one month later. The Bland-Altman method, Spearman coefficients, and a Wilcoxon signed-rank test were used to evaluate the variability, the correlation, and the differences between observers. The interobserver variability for maximal diameter between the two observers was up to 1.2 mm with limits of agreement [-1.5, +0.9] mm; whereas the intraobserver limits were [-1.2, +1.0] mm for the first observer and [-0.8, +0.8] mm for the second observer. The intraobserver CAD variability was 0.8 mm. The correlation was good between observers and the CAD (0.980-0.986); however, significant differences do exist (P<0.001). The maximum variability observed was 1.2 mm and should be considered in reports of measurements of the ascending aorta. The CAD is as reproducible as an experienced reader. |
3 |
| 35. Willemink MJ, Meijs MF, Cramer MJ, et al. Coronary artery assessment on electrocardiogram-gated thoracoabdominal multidetector computed tomographic angiography for aortic evaluation. J Comput Assist Tomogr. 38(2):185-9, 2014 Mar-Apr. |
Observational-Dx |
75 patients |
To evaluate coronary image quality, stenosis grade, and diagnostic confidence in patients undergoing electrocardiogram-gated thoracoabdominal multidetector computed tomographic angiography (CTA) for aortic evaluation. |
Nondiagnostic image quality prohibited coronary evaluation in 14 patients. In the remaining patients, 2% of segments was scored absent, 24% was scored nondiagnostic, 12% was scored diagnostically limited, and 61% was scored at least acceptable. Acceptable or higher image quality was seen in 82% of the proximal and middle segments. Significant stenosis (>50%) was seen in 57% of the patients. Stenosis-severity scoring confidence was moderate to high in 79% of 673 assessable segments. |
4 |
| 36. Natsume K, Shiiya N, Takehara Y, et al. Characterizing saccular aortic arch aneurysms from the geometry-flow dynamics relationship. J Thorac Cardiovasc Surg. 153(6):1413-1420.e1, 2017 06. |
Observational-Dx |
100 patients who underwent contrast-enhanced CT |
To evaluate the geometry of aortic arch aneurysms and their relationship with WSS by using the 4-dimensional flow magnetic resonance imaging to better characterize the saccular aneurysms. |
Eighty-two patients had a saccular aneurysm, and 18 had a fusiform aneurysm. External diameter/aneurysm length ratio and sac depth/neck width ratio of the fusiform aneurysms were constant at 0.76 ± 0.18 and 0.23 ± 0.09, whereas those of saccular aneurysms, especially those involving the outer curvature, were higher and more variable. Vortex flow was always present in the aneurysms, resulting in low WSS. When the sac depth/neck width ratio was less than 0.8, peak WSS correlated inversely with luminal diameter even in the saccular aneurysms. When this ratio exceeded 0.8, which was the case only with the saccular aneurysms, such correlation no longer existed and WSS was invariably low. |
4 |
| 37. Bireley WR 2nd, Diniz LO, Groves EM, Dill K, Carroll TJ, Carr JC. Orthogonal measurement of thoracic aorta luminal diameter using ECG-gated high-resolution contrast-enhanced MR angiography. J Magn Reson Imaging. 26(6):1480-5, 2007 Dec. |
Observational-Dx |
45 Patients |
To compare orthogonal measurements of the thoracic aortic luminal diameter to standard axial measurements within the same patient population using ECGgated high-resolution contrast-enhanced MR angiography (CE-MRA). |
We found that the aorta diameter measurements acquired from axial MRA images were significantly greater (P 0.05) than those acquired from images orthogonal to the course of the aorta at six of seven anatomic sites. Overall, standard axial measurements were found to overestimate luminal diameter of the thoracic aorta by 0.24 cm (95% confidence interval [CI]: 0.14, 0.33) compared to orthogonal measurements. 13.3% of the patients were placed into a greater aorta size classification based on the axial versus the orthogonal measurements. |
3 |
| 38. Clough RE, Waltham M, Giese D, Taylor PR, Schaeffter T. A new imaging method for assessment of aortic dissection using four-dimensional phase contrast magnetic resonance imaging. J Vasc Surg. 55(4):914-23, 2012 Apr. |
Observational-Dx |
12 consecutive patients |
To assess whether four-dimensional phase-contrast magnetic resonance imaging (4D PC-MRI) can accurately visualize and quantify flow characteristics in patients with aortic dissection and whether these features are related to the rate of aortic expansion. |
Comparison of 2D PC-MRI and 4D PC-MRI measurements showed good correlation (Pearson R(2) = 0.98; 95% confidence interval [CI], 0.9818-0.9953; P < .0001) and no proportional bias (bias = 1.0 mL; standard deviation, 4.6). The median aortic growth rate was 6.1 mm/y (interquartile range [IQR], 1.1-15.1 mm/y), and this correlated well with the growth rate of the false lumen (Spearman ? = 0.62; 95% CI, 0.06-0.89; P = .0347). False lumen thrombosis (FLT) was seen in 7 of 12 patients and was not associated with reduced aortic expansion rate (FLT present: 11.4 mm/y; IQR, 3.6-21.4) vs FLT absent: 9.9 mm/y; IQR, 3.4-24.2; Mann-Whitney P = .8763). False lumen stroke volume and velocity were associated with more rapid aortic expansion (? = 0.80 [95% CI, 0.39-0.94; P = .0029] and ? = 0.59 [95% CI, 0.09-0.87; P = .0480] respectively). The position of the dominant entry tear was associated with rapid expansion, which tended to be higher with distal vs proximal entry tears (distal, 21.4 mm/y [IQR, 11.4-48.9] vs proximal, 5.5 mm/y [IQR, 3.4-16.6]; Mann-Whitney P = .096). Helical flow was seen in the false lumen in 8 of 12 patients and was related to the rate of aortic expansion (? = 0.83, P = .0154). |
2 |
| 39. Krishnam MS, Tomasian A, Malik S, Desphande V, Laub G, Ruehm SG. Image quality and diagnostic accuracy of unenhanced SSFP MR angiography compared with conventional contrast-enhanced MR angiography for the assessment of thoracic aortic diseases. Eur Radiol. 20(6):1311-20, 2010 Jun. |
Observational-Dx |
50 patients |
To determine the image quality and diagnostic accuracy of 3-D unenhanced SSFP MRA for the evaluation of thoracic aortic diseases. |
Abnormal aortic findings, including aneurysm (n = 47), coarctation (n = 14), dissection (n = 12), aortic graft (n = 6), IMH (n = 11), mural thrombus in the aortic arch (n = 1), and penetrating aortic ulcer (n = 9), were confidently detected on both datasets. Sensitivity, specificity, and diagnostic accuracy of SSFP MRA for the detection of aortic disease were 100% with contrast enhanced-MRA serving as a reference standard. Image quality of the aortic root was significantly higher on SSFP MRA (P<0.001) with no significant difference for other aortic segments (P>0.05). Signal-to-noise ratio and contrast-to-noise ratio values were higher for all segments on SSFP MRA (P<0.01). |
3 |
| 40. Strayer RJ.. Thoracic Aortic Syndromes. [Review]. Emerg Med Clin North Am. 35(4):713-725, 2017 Nov. |
Review/Other-Dx |
N/A |
To describe Aortic dissection (AD) which indicate advanced aortic imaging with CT, MRI, or TEE if high-risk markers are established. |
No results provided |
4 |
| 41. Laissy JP, Blanc F, Soyer P, et al. Thoracic aortic dissection: diagnosis with transesophageal echocardiography versus MR imaging. Radiology. 1995;194(2):331-336. |
Observational-Dx |
41 patients |
Retrospective study to compare TEE and MRI in diagnosis of dissection of thoracic aorta. Imaging results compared at independent double-blind readings. |
MRI depicted intimal flap in 95% ADs; TEE in 86% (P<0.05). Sensitivity for MRI for detection of residual dissection 100% vs 86% with TEE. Inferior extent dissection seen only with MRI. MRI superior to TEE in follow-up thoracic AD. However, because of limited MRI availability, TEE should remain standard modality for diagnosis. |
2 |
| 42. 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 |
| 43. Liu F, Huang L. Usefulness of ultrasound in the management of aortic dissection. [Review]. Rev Cardiovasc Med. 19(3):103-109, 2018 Sep 30. |
Review/Other-Dx |
N/A |
To discuss the benefits of ultrasound used for diagnosis, treatment and prognostic evaluation of aortic dissection. |
No results provided |
4 |
| 44. van Kesteren F, Elattar MA, van Lienden KP, Baan J Jr, Marquering HA, Planken RN. Non-contrast enhanced navigator-gated balanced steady state free precession magnetic resonance angiography as a preferred magnetic resonance technique for assessment of the thoracic aorta. Clin Radiol. 72(8):695.e1-695.e6, 2017 Aug. |
Observational-Dx |
50 patients with thoracic aortic disease |
To compare the objective and subjective image quality of non-contrast three-dimensional (3D) navigator-gated balanced steady state free precession magnetic resonance angiography (NC-MRA) and contrast-enhanced magnetic resonance angiography (CE-MRA) along the entire thoracic aorta. |
NC-MRA resulted in significantly sharper delineation of the aortic root, ascending aorta, and distal descending aorta compared to CE-MRA. Sharpness was comparable at the level of the arch and proximal descending aorta. NC-MRA resulted in significantly better subjective image quality. Interobserver agreement for diameter measurements was excellent for both techniques. |
2 |
| 45. Zhu C, Tian B, Leach JR, et al. Non-contrast 3D black blood MRI for abdominal aortic aneurysm surveillance: comparison with CT angiography. European Radiology. 27(5):1787-1794, 2017 May.Eur Radiol. 27(5):1787-1794, 2017 May. |
Observational-Dx |
28 patients with AAAs |
To 1) validate non-contrast MRI for measuring AAA diameter, and 2) to assess ILT with CTA and MRI. |
Strong agreement between CTA and non-contrast MRI was shown for AAA diameter (intra-class coefficient > 0.99). Both approaches had excellent inter-observer reproducibility (ICC > 0.99). ILT appeared homogenous on CTA, whereas MRI revealed compositional variations. Patients with AAAs =5.5 cm and <5.5 cm had a variety of distributions of old/fresh ILT types. |
1 |
| 46. 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 |
| 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. Sohns JM, Staab W, Menke J, et al. Vascular and extravascular findings on magnetic resonance angiography of the thoracic aorta and the origin of the great vessels. J Magn Reson Imaging. 40(4):988-95, 2014 Oct. |
Observational-Dx |
165 patients that underwent 1.5 T MRA of the thorax |
To investigate the presence of relevant vascular and incidental extravascular findings in patients undergoing magnetic resonance angiography (MRA) of the thoracic aorta and origin of the great vessels. |
A total of 306 relevant vascular findings were found in our cohort. A total of 397 extravascular findings were observed among the patients and were classified as Group A findings in 81.9% (325/397 findings, observed in 146 of 165 patients), as Group B findings in 15.4% (61/397 findings, observed in 52 of 165 patients), and as Group C in 2.8% of findings (11/397). The clinically relevant Group C findings were observed in 6.7% of patients (11/165), comprising eight previously unknown neoplasms (4.8% of 165), two patients with hemodynamically relevant pericardial effusion (1.2% of 165), and one patient with spondylodiscitis (0.6% of 165) detected by MRA. |
3 |
| 49. Kramer U, Fenchel M, Laub G, et al. Low-dose, time-resolved, contrast-enhanced 3D MR angiography in the assessment of the abdominal aorta and its major branches at 3 Tesla. Acad Radiol. 17(5):564-76, 2010 May. |
Observational-Dx |
22 patients |
To evaluate the effectiveness of low-dose, contrast-enhanced (CE), time-resolved, three-dimensional magnetic resonance angiography (MRA) in the assessment of the abdominal aorta and its major branches at 3 T and to compare the results with those of high-spatial resolution CE MRA. |
A total of 242 arterial segments were visualized with good image quality. Time-resolved MRA was able to visualize the majority of arterial segments with good definition in the diagnostic range. Vascular pathologies (stenosis, occlusion) or abnormal vascular anatomy was detected in 19 arterial segments, with good interobserver agreement (kappa = 0.78). All image findings were detected with time-resolved CE MRA by both observers and were confirmed by correlative imaging. |
1 |
| 50. Srichai MB, Kim S, Axel L, Babb J, Hecht EM. Non-gadolinium-enhanced 3-dimensional magnetic resonance angiography for the evaluation of thoracic aortic disease: a preliminary experience. Tex Heart Inst J. 37(1):58-65, 2010. |
Observational-Dx |
21 patients who underwent NC-MRA and CE-MRA |
To compare image quality and diagnostic accuracy of a noncontrast 3-dimensional magnetic resonance angiography (NC-MRA) technique (balanced steady-state free-precession sequence) to contrast-enhanced MRA (CE-MRA) for evaluation of thoracic aortic disease. |
Twenty-one patients (mean age, 51 yr; 18 men) who underwent NC-MRA and CE-MRA for evaluation of thoracic aortic disease were retrospectively identified. Data sets were reviewed by 2 readers who were blinded to the patients' information. The thoracic aorta was divided into 5 segments. Image quality and reader confidence for diagnosis of aortic pathology were rated on 5-point scales. The Wilcoxon matched-pairs signed rank test and the Student t test were used for comparisons.The NC-MRA identified all pathologic findings with 100% diagnostic accuracy and similar reader confidence, when compared with CE-MRA. Although overall image quality was not significantly different, superior image quality was observed at the aortic root (4.4 +/- 0.8 vs 3.2 +/- 0.9, P <0.0005) and ascending aorta (4.1 +/- 1 vs 3.7 +/- 0.9, P=0.05) respectively. |
2 |
| 51. von Knobelsdorff-Brenkenhoff F, Gruettner H, Trauzeddel RF, Greiser A, Schulz-Menger J. Comparison of native high-resolution 3D and contrast-enhanced MR angiography for assessing the thoracic aorta. Eur Heart J Cardiovasc Imaging. 15(6):651-8, 2014 Jun. |
Observational-Dx |
76 patients with known or suspicion of thoracic aortic disease |
To evaluate a native steady-state free precession (SSFP) three-dimensional (3D) MRA in comparison with contrast-enhanced MRA as the gold standard. |
Native 3D MRA was acquired successfully in 70 of 76 subjects (mean acquisition time 8.6 ± 2.7 min), while irregular breathing excluded 6 of 76 subjects. Aortic diameters agreed close between both methods at all aortic levels (r = 0.99; bias ± SD -0.12 ± 1.2 mm) with low intra- and inter-observer dependency (intraclass correlation coefficient 0.99). Native MRA studies resulted in the same final diagnosis as the contrast-enhanced MRA. The mean image quality score was superior with native compared with contrast-enhanced MRA (2.4 ± 0.6 vs. 1.6 ± 0.5; P < 0.001). |
2 |
| 52. Zhu C, Leach JR, Tian B, et al. Evaluation of the distribution and progression of intraluminal thrombus in abdominal aortic aneurysms using high-resolution MRI. Journal of Magnetic Resonance Imaging. 50(3):994-1001, 2019 09.J Magn Reson Imaging. 50(3):994-1001, 2019 09. |
Observational-Dx |
80 patients with AAA |
1) To characterize the relationship between ILT signal intensity and AAA diameter; 2) to evaluate ILT change over time; and 3) to assess the relationship between ILT features and AAA growth. |
AAAs with Type 1 ILT were larger than those with Types 2 and 3 ILT (5.1 ± 1.1 cm, 4.4 ± 0.9 cm, 4.2 ± 0.8 cm, P = 0.008). The growth rate of AAAs with Type 1 ILT was significantly greater than that of AAAs with Types 2 and 3 ILT (2.6 ± 2.5, 0.6 ± 1.3, 1.5 ± 0.6 mm/year, P = 0.01). During follow-up, AAAs with active ILT changes had a 3-fold increased growth rate compared with AAAs with stable ILT (3.6 ± 3.0 mm/year vs. 1.2 ± 1.5 mm/year, P = 0.008). |
3 |
| 53. Lai V, Tsang WK, Chan WC, Yeung TW. Diagnostic accuracy of mediastinal width measurement on posteroanterior and anteroposterior chest radiographs in the depiction of acute nontraumatic thoracic aortic dissection. EMERG. RADIOL.. 19(4):309-15, 2012 Aug. |
Observational-Dx |
220 patients |
To explore the diagnostic accuracy of various mediastinal measurements in determining acute nontraumatic thoracic AD with respect to posteroanterior and anteroposterior chest radiographs. |
The maximal mediastinal width and maximal left mediastinal width were measured by 2 independent radiologists and the mediastinal width ratio was calculated. Statistical analysis was then performed with independent sample t test. Posteroanterior projection was significantly more accurate than anteroposterior projection, achieving higher sensitivity and specificity. Left mediastinal width and mediastinal width were the most powerful parameters on posteroanterior and anteroposterior chest radiographs, respectively. The optimal cutoff levels were left mediastinal width = 4.95 cm (sensitivity, 90%; specificity, 90%) and mediastinal width = 7.45 cm (sensitivity, 90%; specificity, 88.3%) for posteroanterior projection and left mediastinal width = 5.45 cm (sensitivity, 76%; specificity, 65%) and mediastinal width = 8.65 cm (sensitivity, 72%; specificity, 80%) for anteroposterior projection. Mediastinal width ratio was found less useful and less reliable. The use of left mediastinal width alone in posteroanterior film would allow more accurate prediction of AD. Posteroanterior chest radiograph has a higher diagnostic accuracy when compared with AP chest radiograph, with negative posteroanterior chest radiograph showing less probability for AD. |
3 |
| 54. Mongeon FP, Marcotte F, Terrone DG. Multimodality Noninvasive Imaging of Thoracic Aortic Aneurysms: Time to Standardize?. [Review]. Can J Cardiol. 32(1):48-59, 2016 Jan. |
Review/Other-Dx |
N/A |
To discuss noninvasive aortic imaging which is an essential part of a surveillance program for patients with a confirmed or suspected aortopathy because aortic size is crucial for predicting the risk of death, aortic rupture, or aortic dissection. |
No results provided |
4 |
| 55. von Kodolitsch Y, Nienaber CA, Dieckmann C, et al. Chest radiography for the diagnosis of acute aortic syndrome. Am J Med. 2004; 116(2):73-77. |
Observational-Dx |
216 patients |
To assess the diagnostic accuracy of routine chest radiography for the acute aortic syndrome (dissection, IMH, penetrating ulcer, or nondissecting aneurysm). |
Chest radiography had a sensitivity of 64% (70/109) and a specificity of 86% (92/107) for aortic disease. Sensitivity was 67% (38/57) for overt aortic dissection, 61% (22/36) for nondissecting aneurysm, and 63% (10/16) for intramural hemorrhage or penetrating ulcer. However, sensitivity was lower for pathology confined to the proximal aorta (47% [21/45]) than for disease involving distal aortic segments (77% [49/64]). A receiver operating characteristic curve analysis of aortic diameters failed to identify a threshold for the diagnosis of aortic disease. |
1 |
| 56. das Chagas de Azevedo F, Zerati AE, Blasbalg R, Wolosker N, Puech-Leao P. Comparison of ultrasonography, computed tomography, and magnetic resonance imaging with intraoperative measurements in the evaluation of abdominal aortic aneurysms. Clinics. 60(1):21-8, 2005 Feb. |
Observational-Dx |
60 patients |
To study the imaging exams more commonly used for abdominal aortic aneurysms evaluation - ultrasonography, conventional computerized tomography, helical computerized tomography and nuclear magnetic angioresonance - comparing the preoperative measurements reached by those radiological methods with the measurements made during the surgical procedures. |
The maximum transverse diameter had a range measurement variation of 4.5 to 13.6 cm in the intraoperative, with no statistically significant differences when compared with all the imaging tests. The ultrasonography, however, overestimated the measurements of the proximal neck and the common iliac arteries, in comparison with intraoperative measures. The length of the aorta aneurysm obtained by the conventional computerized tomography was significantly lower if compared to the measures done with the calliper during the operation. The helical computerized tomography and the nuclear magnetic angioresonance provided measurements with no significant differences in the statistic view when compared to the intraoperative measures. |
3 |
| 57. Evangelista A, Flachskampf FA, Erbel R, et al. Echocardiography in aortic diseases: EAE recommendations for clinical practice. Eur J Echocardiogr. 11(8):645-58, 2010 Sep. |
Review/Other-Dx |
N/A |
To discuss European Association of Echocardiography (EAE) recommendations for echocardiography in aortic diseases. |
No results stated. |
4 |
| 58. Diercks DB, Promes SB, Schuur JD, Shah K, Valente JH, Cantrill SV. Clinical policy: critical issues in the evaluation and management of adult patients with suspected acute nontraumatic thoracic aortic dissection. Ann Emerg Med 2015;65:32-42 e12. |
Review/Other-Dx |
N/A |
To address key issues in the evaluation and management of patients with suspected acute nontraumatic thoracic aortic dissection. |
No abstract available |
4 |
| 59. Ueda T, Fleischmann D, Rubin GD, Dake MD, Sze DY. Imaging of the thoracic aorta before and after stent-graft repair of aneurysms and dissections. [Review] [34 refs]. Semin Thorac Cardiovasc Surg. 20(4):348-357, 2008. |
Review/Other-Dx |
N/A |
To review state-of-the-art pre- and postprocedural imaging for TEVAR, especially focusing on the role of MDCT angiography. |
No results provided |
4 |
| 60. Alric P, Canaud L, Branchereau P, Marty-Ane C, Berthet JP. Preoperative assessment of anatomical suitability for thoracic endovascular aortic repair. Acta Chir Belg. 109(4):458-64, 2009 Jul-Aug. |
Review/Other-Dx |
N/A |
To provide a preoperative assessment of anatomical suitability for thoracic endovascular aortic repair. |
No results stated in abstract |
4 |
| 61. Goshima S, Kanematsu M, Kondo H, et al. Preoperative planning for endovascular aortic repair of abdominal aortic aneurysms: feasibility of nonenhanced MR angiography versus contrast-enhanced CT angiography. Radiology. 267(3):948-55, 2013 Jun. |
Observational-Dx |
50 Patients |
To compare vascular measurements to determine stent types and configurations for abdominal endovascular aneurysm repair (EVAR) by comparing results of contrast material-enhanced computed tomographic (CT) angiography and nonenhanced magnetic resonance (MR) angiography. |
No significant difference was found in aortic neck diameter (observer 1: CT, 18.5 mm; MR, 19.0 mm; P = .43) (observer 2: CT, 19.6 mm; MR, 19.3 mm; P = .59), aortic neck diameter 15 mm distal to the lowest renal artery (observer 1: CT, 19.2 mm; MR, 19.2 mm; P = .38) (observer 2: CT, 19.6 mm; MR, 19.6 mm; P = .91), aortic neck length (observer 1: CT, 43.6 mm; MR, 43.6 mm; P = .85) (observer 2: CT, 44.4 mm; MR, 44.0 mm; P = .93), or other key vascular measurements (P = .23-.99) for preoperative planning. These included aneurysm diameter, lowest renal artery to aortic bifurcation length, aortic bifurcation diameter, common iliac artery diameters, external iliac artery diameters, length between orifices of lower renal and internal iliac arteries, and iliac artery sealing length. CT and MR angiography measurements showed very strong correlation (r = 0.92-0.99). Intraclass correlation coefficients between observers ranged from 0.90 to 0.98. Stent types and configurations determined with CT measurements remained unaltered when reassessed with MR measurements. |
1 |
| 62. Lutz AM, Willmann JK, Pfammatter T, et al. Evaluation of aortoiliac aneurysm before endovascular repair: comparison of contrast-enhanced magnetic resonance angiography with multidetector row computed tomographic angiography with an automated analysis software tool. J Vasc Surg. 37(3):619-27, 2003 Mar. |
Observational-Dx |
20 patients |
To assess accuracy and reliability of a volumetric analysis of abdominal aneurysms on the basis of multidetector row computed tomographic angiography (CTA) and magnetic resonance angiography (MRA) with a commercially available automated vessel analysis software program. |
With the automated analysis software tool, all measurements could be performed on either CTA or MRA data sets. There was no statistically significant difference between postdeployment measurements of stent graft length on CTA and the true dimensions of the implanted stent grafts. Interobserver agreement for all of the measurements with either CTA or MRA was good to excellent (interclass coefficient, 0.71 to 0.99) with only minimal mean differences of measured dimensions between both readers (range, -2.0 to +2.3 mm, Bland-Altman). Intermodality agreement between CTA and MRA was good to excellent (interclass coefficient, 0.62 to 0.98) with small mean differences of measured dimensions between both methods (range, -4.1 to +2.1 mm, Bland-Altman). |
1 |
| 63. Shaida N, Bowden DJ, Barrett T, et al. Acceptability of virtual unenhanced CT of the aorta as a replacement for the conventional unenhanced phase. Clin Radiol. 67(5):461-7, 2012 May. |
Observational-Dx |
49 patients |
To evaluate whether virtual unenhanced CT images generated of the aorta were of sufficient quality to replace the conventional unenhanced images. |
The attenuation was significantly higher in the virtual unenhanced images compared to the conventional unenhanced images within the thoracic aorta (P<0.01) but not within the abdominal aorta (P=0.15). Overall the virtual unenhanced images of the abdominal aorta were deemed acceptable as replacements for the conventional unenhanced images in 93% of cases. For the thoracic aorta, the virtual unenhanced images were deemed acceptable in only 12% of cases, primarily due to pulsation artifact. |
4 |
| 64. Karkkainen JM, Pather K, Tenorio ER, Mees B, Oderich GS. Should endovascular approach be considered as the first option for thoraco-abdominal aortic aneurysms?. [Review]. J Cardiovasc Surg (Torino). 60(3):298-312, 2019 Jun. |
Review/Other-Dx |
N/A |
To review the current technical aspects of endovascular TAAA repair with the main focus on the evidence of open versus endovascular outcomes of TAAA repair. |
No results provided |
4 |
| 65. Pini R, Faggioli G, Gallitto E, et al. The different effect of branches and fenestrations on early and long-term visceral vessel patency in complex aortic endovascular repair. Journal of Vascular Surgery. 71(4):1128-1134, 2020 04. |
Observational-Tx |
158 patients |
To evaluate the VV loss (VVL) according to the type of revascularization performed (fenestrations vs branched) and the necessity for adjunctive visceral procedures (AVPs). |
In 158 patients, 523 VVs were considered, 140 (26%) in JAAAs, 165 (32%) in PAAAs, and 218 (42%) in TAAAs. Branches were used for 114 vessels (52%) in TAAAs, 8 (5%) in PAAAs, and 0 (0%) in JAAAs. The overall perioperative VVL was 20 (3.8%) and was significantly greater in TAAAs than in PAAAs or JAAAs (6.4% vs 2.4% vs 1.4%; P = .03). The branches resulted in greater perioperative VVL compared with fenestration (9% [11 of 122] vs 2% [9 of 401]; P = .0001). A significant VVL difference between the branches and fenestrations was identified selectively only for the renal arteries: 11 of 52 (21%) vs 6 of 224 (2.5%; P = .001). The results of the multivariate analysis confirmed the independent greater risk of VVL for branches and renal arteries (odds ratio, 4.7; 95% confidence interval, 12.5-1.7; P = .04; odds ratio, 7.1; 95% confidence interval, 52.6-1.05; P = .05, respectively). AVPs were performed in 43 VVs (8.2%) because of dissection (n = 2; 0.4%), stenosis (m = 3; 0.6%), bleeding (n = 3; 0.6%), or kinking between the bridging stent graft and the VV (n = 35; 7%). A significant difference between the branches and fenestrations was seen only for kinking between the bridging stent graft and VV (12% [15 of 112] vs 5% [20 of 401]; P = .005). At 5 years, the incidence of VVL was 2% ± 1%. The fenestrations had significantly greater freedom from VVL compared with the branches (100% vs 87% ± 6%; P = .04), which was confirmed selectively for TAAAs (100% vs 87% ± 6%; P = .04). The use of AVPs did not affect long-term visceral patency. |
2 |
| 66. Meinel FG, Nikolaou K, Weidenhagen R, et al. Time-resolved CT angiography in aortic dissection. Eur J Radiol. 81(11):3254-61, 2012 Nov. |
Observational-Dx |
14 patients with known or suspected aortic dissection |
To assess feasibility and additional diagnostic value of time-resolved CT angiography of the entire aorta in patients with aortic dissection. |
Mean effective radiation dose was 27.7±3.5 mSv. CT density of the true lumen peaked at 355±53 HU. Compared to the simulated triphasic protocol, time-resolved CT angiography added diagnostic information regarding a number of important findings: the enhancement delay between true and false lumen (n=14); the degree of membrane oscillation (n=14); the perfusion delay in arteries originating from the false lumen (n=9). Other additional information included true lumen collapse (n=4), quantitative assessment of renal perfusion asymmetry (n=2), and dynamic occlusion of aortic branches (n=2). In 3/14 patients (21%), these additional findings of the multiphasic protocol altered patient management. |
2 |
| 67. Wolf F, Plank C, Beitzke D, et al. Prospective evaluation of high-resolution MRI using gadofosveset for stent-graft planning: comparison with CT angiography in 30 patients. AJR Am J Roentgenol. 197(5):1251-7, 2011 Nov. |
Observational-Dx |
30 consecutive patients |
To compare high-resolution gadofosveset-enhanced MRA with the reference standard CTA in planning EVAR of AAA. |
Diameter and length measurements showed small but significant differences (P<0.001) between MRA and CTA. Stent-graft selection according to these measurements showed 100% concordance between both modalities. Subjective imaging parameters showed significantly better results for CTA compared with MRA (P<0.001). In this study, MRA using a blood pool contrast agent has shown the ability to provide reliable and exact measurements before EVAR, allowing noninvasive planning of the intervention despite lower image-quality and without the disadvantages of ionizing radiation and nephrotoxicity. |
2 |
| 68. Abdelbaky M, Zafar MA, Saeyeldin A, et al. Routine anterior spinal artery visualization prior to descending and thoracoabdominal aneurysm repair: High detection success. J Card Surg. 34(12):1563-1568, 2019 Dec. |
Observational-Dx |
177 patients |
To present our experience with routine application of enhanced imaging techniques to detect the anterior spinal artery (ASA) before DTAA and TAAA repair. |
The imaging protocol successfully detected the level of the ASA in 132 (74.5%) patients, utilizing CTA in 67, DECT in 28, spinal angiography in 31, and MRA in 6. Cross sectional modalities with advanced visualization technique (CT, DECT, and MRA) were more successful at detecting the ASA than angiography (80.72%, 82.35%, 75% vs 59.62%, respectively, P = .04). Concerted efforts were made not to leave the operating room without continuity of the ASA with the circulation (via limited resection, beveled anastomosis, or reimplantation). Transient lower extremity weakness was observed in 11 (6.2%) patients, and permanent paraplegia in 2 (1.12%) patients. |
3 |
| 69. Takagi H, Ota H, Natsuaki Y, et al. Identifying the Adamkiewicz artery using 3-T time-resolved magnetic resonance angiography: its role in addition to multidetector computed tomography angiography. Jpn J Radiol. 33(12):749-56, 2015 Dec. |
Observational-Dx |
117 patients with thoracoabdominal aortic disease |
This study assessed Adamkiewicz artery (AKA) detectability using multidetector computed tomography angiography (MDCTA) and time-resolved magnetic resonance angiography (MRA) at 3 T. |
AKA detectability was at 80.2% (89/111) using MDCTA and 89.8% (44/49) with MRA. In the 43 patients who underwent both MDTCA and MRA, the AKA detectability and consensus grades were significantly elevated using MRA vs. MDCTA (detectability: 88.4 vs. 69.8%, respectively, p = 0.043). AKA detectability was also higher in aortic aneurysm than aortic dissection patients on MDCTA (90.9 vs. 69.6%, respectively, p < 0.01), but not on MRA (92.9 vs. 88.6%, respectively, p = 0.99). |
3 |
| 70. Nijenhuis RJ, Jacobs MJ, Jaspers K, et al. Comparison of magnetic resonance with computed tomography angiography for preoperative localization of the Adamkiewicz artery in thoracoabdominal aortic aneurysm patients. J Vasc Surg. 45(4):677-85, 2007 Apr. |
Observational-Dx |
39 patients with a TAA or a TAAA |
To investigate whether MRA or CTA is the preferred technique for the preoperative visualization of the Adamkiewicz artery in white thoracoabdominal aortic aneurysm (TAAA) patients. |
Average detection rate for Adamkiewicz artery localization was 71% (67% to 74%) for CTA and 97% (94% to 100%) for MRA. Interobserver agreement was 82% for CTA and 94% for MRA. Signal-to-noise ratio was significantly higher (P < .001) and contrast-to-noise ratio was significantly (P < .001) lower for CTA than for MRA. Contrast of the Adamkiewicz artery (P < .001) and overall image quality (P < .004) were judged to be significantly better for MRA. Spinal cord tissue enhancement was judged stronger at CTA (P < .03), with significantly less epidural venous enhancement (P < .001). No significant difference was found in image noise. Signal-to-noise and contrast-to-noise decreased significantly (P < .001) with increasing patient thickness for CTA but not for MRA. |
1 |
| 71. Tanaka H, Ogino H, Minatoya K, et al. The impact of preoperative identification of the Adamkiewicz artery on descending and thoracoabdominal aortic repair. J Thorac Cardiovasc Surg. 151(1):122-8, 2016 Jan. |
Observational-Tx |
1252 patients (descending/thoracoabdominal aortic repairs) |
To investigate the impact of preoperative identification of the Adamkiewicz artery (AKA) on prevention of spinal cord injury (SCI) through the multicenter Japanese Study of Spinal Cord Protection in Descending and Thoracoabdominal Aortic Repair (JASPAR) registry. |
The AKA was identified in 1096 of the 1252 patients who underwent preoperative imaging (87.6%). Hospital mortality was 9.2% (n = 136) in those who underwent OR and 6.4% (n = 62) in those who underwent EVR. The incidence of SCI was 7.3% in the OR group (descending, 4.2%; Ex I, 9.4%; Ex II, 14.0%; Ex III, 14.4%; Ex IV, 4.2 %; Ex V, 7.2%) and 2.9% in the EVR group. The risk factors for SCI in ORs were advanced age, extended repair, emergency, and occluded bilateral hypogastric arteries. In ORs of the aortic segment involving the AKA, having no AKA reconstruction was a significant risk factor for SCI (odds ratio, 2.79, 95% confidence interval, 1.14-6.79; P = .024). |
3 |
| 72. Yoshioka K, Tanaka R, Takagi H, et al. Ultra-high-resolution CT angiography of the artery of Adamkiewicz: a feasibility study. Neuroradiology. 60(1):109-115, 2018 Jan. |
Observational-Dx |
24 patients with thoracic and thoracoabdominal aneurysms |
To evaluate the usefulness of ultra-high-resolution CT for visualizing the artery of Adamkiewicz with a slice thickness of 0.25 versus 0.5 mm in patients with aortic aneurysms. |
No significant differences in the SNR of the aorta or CNR of the anterior spinal artery were observed between 0.25- and 0.5-mm slices. The average visualization score was significantly higher for 0.25-mm slices (3.58 ± 0.78) than for 0.5-mm slices (3.13 ± 0.99) (p = 0.01). The percentage of patients with nondiagnostic image quality was significantly lower for 0.25-mm slices (8.3%) than for 0.5-mm slices (33.3%) (p = 0.03). |
2 |
| 73. Amako M, Yamamoto Y, Nakamura K, et al. Preoperative visualization of the artery of Adamkiewicz by dual-phase CT angiography in patients with aortic aneurysm. Kurume Med J. 58(4):117-25, 2011. |
Experimental-Dx |
110 patients |
To develop a modified intravenous CT angiography technique to improve our ability to visualize the Adamkiewicz artery (AKA). |
In RA-CT angiography, contrast medium with a high iodine concentration (370 mg/dl) was injected twice into the right atrium at a high injection rate (8.0 ml/sec), and two CT scans, starting at 20 sec after the first injection and at 35 sec after the second injection, respectively, were performed. All CT images were obtained using an 8- or 16-detector CT scanner at a slice thickness of 0.625 mm. The AKA was defined as the largest radiculomedullary artery with a characteristic hairpin turn, and with continuity from the aorta to the ASA.The AKA with hairpin turn was detected in all patients (100%), and continuity from the aorta to the ASA was confirmed in 99 of the 110 patients (90.0%). The AKA arose between Th8 and L1 in 86 of these patients (86.8%), and originated from the left side in 71 patients (71.7%). |
2 |
| 74. Piacentino F, Fontana F, Micieli C, et al. Nonenhanced MRI Planning for Endovascular Repair of Abdominal Aortic Aneurysms: Comparison With Contrast-Enhanced CT Angiography. Vascular & Endovascular Surgery. 52(1):39-45, 2018 Jan. |
Observational-Dx |
30 patients admitted for elective EVAR |
To assess whether noncontrast-enhanced magnetic resonance imaging (NC-MRI) is an alternative to contrast-enhanced computed tomography angiography (CTA) for aortoiliac measurements before endovascular abdominal aortic aneurysm repair (EVAR). |
Concerning all measurements, no significant difference was found. Both CTA and NC-MRI angiographic measurements showed strong correlation. Interobserver ICCs for CTA and NC-MRI showed ranges of 0.62 to 0.99 (mean: 0.92) and 0.56 to 0.99 (mean: 0.91); intermodality ICCs for observer 1 and 2 showed ranges of 0.64 to 0.99 (mean: 0.92) and 0.56 to 0.99 (mean: 0.92). The CTA and NC-MRI vascular measurements correlated strongly, except for both external iliac artery diameters. The choice of stent size was always the same between the 2 observers; furthermore, graft size was always in agreement with that selected prospectively. |
2 |
| 75. Armerding MD, Rubin GD, Beaulieu CF, et al. Aortic aneurysmal disease: assessment of stent-graft treatment-CT versus conventional angiography. Radiology. 2000; 215(1):138-146. |
Observational-Dx |
40 patients |
To compare CTA and conventional angiography for determining the success of endoluminal stent-graft treatment of aortic aneurysms. |
20 perigraft leaks were detected in the results of 46 examinations. Sensitivities and specificities for detecting perigraft leakage were 63% and 77% for conventional angiography and 92% and 90% for CTA, respectively. The kappa value was 0. 41 for conventional angiography and 0.81 for CTA. CTA is the preferred method for establishing the presence of perigraft leakage following treatment of aortoiliac aneurysms with stent-grafts. |
1 |
| 76. Hallett RL, Ullery BW, Fleischmann D. Abdominal aortic aneurysms: pre- and post-procedural imaging. [Review]. Abdominal Radiology. 43(5):1044-1066, 2018 05. |
Review/Other-Dx |
N/A |
To discuss the current role of imaging in the assessment of AAA patients prior to intervention, in evaluation of procedural complications, and in long-term follow-up of EVAR patients. |
No results provided |
4 |
| 77. Flors L, Leiva-Salinas C, Norton PT, Patrie JT, Hagspiel KD. Imaging follow-up of endovascular repair of type B aortic dissection with dual-source, dual-energy CT and late delayed-phase scans. Journal of Vascular & Interventional Radiology. 25(3):435-42, 2014 Mar. |
Observational-Dx |
24 patients with TEVAR for type B dissection |
To evaluate the diagnostic performance of dual-energy (DE) computed tomography (CT) after thoracic endovascular aortic repair (TEVAR) of type B dissection, and to investigate the value of late delayed (LD) acquisition in endoleak detection and false lumen patency assessment. |
Session A revealed 37 endoleaks in 30 of 53 studies (56.6%). Session B revealed 31 of the 37 endoleaks, with one false-positive case, 83.8% sensitivity, 95.8% specificity, 79.3% negative predictive value, and 96.9% positive predictive value. Session C correctly depicted all 37 endoleaks, with one false-positive case, 100% sensitivity, 95.8% specificity, 100% negative predictive value, and 97.4% positive predictive value. Underestimation of false lumen patency was found in session B (P = .013). Virtual noncontrast imaging resulted in 17% radiation exposure reduction. |
2 |
| 78. Alerci M, Oberson M, Fogliata A, Gallino A, Vock P, Wyttenbach R. Prospective, intraindividual comparison of MRI versus MDCT for endoleak detection after endovascular repair of abdominal aortic aneurysms. Eur Radiol. 19(5):1223-31, 2009 May. |
Observational-Dx |
43 patients |
To compare MRI and MDCT for endoleak detection after endovascular repair of abdominal aortic aneurysms (EVAR). |
Twenty endoleaks were detected in 18 patients at consensus reading (12 type II and 8 indeterminate endoleaks). Sensitivity, specificity, and accuracy for endoleak detection were 100%, 92%, and 96%, respectively, for reader 1 (95%, 81%, 87% for reader 2) for MRI and 55%, 100%, and 80% for reader 1 (60%, 100%, 82% for reader 2) for MDCT. Interobserver agreement was excellent for MDCT (k = 0.96) and good for MRI (k = 0.81). MRI with the use of a high-relaxivity contrast agent is significantly superior in the detection of endoleaks after EVAR compared with MDCT. MRI may therefore become the preferred technique for patient follow-up after EVAR. |
2 |
| 79. Habets J, Zandvoort HJ, Reitsma JB, et al. Magnetic resonance imaging is more sensitive than computed tomography angiography for the detection of endoleaks after endovascular abdominal aortic aneurysm repair: a systematic review. [Review]. Eur J Vasc Endovasc Surg. 45(4):340-50, 2013 Apr. |
Review/Other-Dx |
11 Articles; 369 Patients |
The purpose of this systematic review was to examine whether magnetic resonance imaging (MRI) or computed tomography angiography (CTA) is more sensitive for the detection of endoleaks in patients with abdominal aortic aneurysm (AAA) after EVAR. |
Eleven articles were included. The overall methodological quality of the articles was good. In total, 369 patients with 562 MRI and 562 CTA examinations were included. A total of 146 endoleaks were detected by CTA; MRI detected all but two of these endoleaks. With MRI 132 additional endoleaks were found. |
4 |
| 80. Kret MR, Azarbal AF, Mitchell EL, Liem TK, Landry GJ, Moneta GL. Compliance with long-term surveillance recommendations following endovascular aneurysm repair or type B aortic dissection. J Vasc Surg. 58(1):25-31, 2013 Jul. |
Review/Other-Tx |
204 patients |
To determine factors associated with failure to obtain recommended lifelong surveillance for both endovascular aneurysm repair and acute. |
Two hundred four patients, median age 71.9 years, were identified; 171 had EVAR and 33 had type B dissection. EVAR patients included 45 thoracic, 100 abdominal, and 12 thoracoabdominal endografts, as well as 7 iliac artery aneurysm repairs and 7 proximal/distal graft extensions. Median follow-up was 28 +/- 10.5 months. Overall, 56% were lost to follow-up, whereas 11% never returned for surveillance after initial hospitalization. Follow-up was compared for each of the comorbidities and socioeconomic factors; none were found to significantly affect follow-up. The known complication rate was 9.3% (n = 19), with reintervention performed in 14% of EVAR/TEVAR patients. Thirty-eight percent of medically managed patients with type B dissections eventually required surgical intervention. All-cause 5-year mortality was 27% as determined by the Social Security Death Index. |
4 |
| 81. Javor D, Wressnegger A, Unterhumer S, et al. Endoleak detection using single-acquisition split-bolus dual-energy computer tomography (DECT). Eur Radiol. 27(4):1622-1630, 2017 Apr. |
Observational-Dx |
50 patients |
To assess a single-phase, dual-energy computed tomography (DECT) with a split-bolus technique and reconstruction of virtual non-enhanced images for the detection of endoleaks after endovascular aneurysm repair (EVAR). |
The analysis showed a significant reduction of radiation dose of up to 42 %, using the single-acquisition split-bolus protocol, while maintaining a comparable diagnostic accuracy (primary endoleak detection rate of 96 %). Image quality between the two protocols was comparable and only slightly inferior for the split-bolus scan (2.5 vs. 2.4). |
1 |
| 82. Guo Q, Zhao J, Huang B, et al. A Systematic Review of Ultrasound or Magnetic Resonance Imaging Compared With Computed Tomography for Endoleak Detection and Aneurysm Diameter Measurement After Endovascular Aneurysm Repair. [Review]. J Endovasc Ther. 23(6):936-943, 2016 Dec. |
Review/Other-Dx |
31 studies and 3853 patients |
To analyze the literature comparing ultrasound [duplex (DUS) or contrast-enhanced (CEUS)] or magnetic resonance imaging (MRI) with computed tomography angiography (CTA) for endoleak detection and aneurysm diameter measurement after endovascular aneurysm repair (EVAR). |
Endoleaks were seen in 25.6% (985/3853) of patients after EVAR. Fifteen studies compared DUS with CTA for the detection of all endoleak types. CTA had a significantly higher proportion of additional endoleaks detected (214/2346 vs 77/2346 for DUS). Of 19 studies comparing CEUS with CTA for the detection of all endoleak types, CEUS was more sensitive (138/1694) vs CTA (51/1694). MRI detected 42 additional endoleaks that were undetected by CTA during the paired scans, whereas CTA detected 2 additional endoleaks that MRI did not show. CTA had a similar proportion of additional types I and III endoleaks undetected by CEUS or MRI. Of 9 studies comparing ultrasound vs CTA for post-EVAR aneurysm diameter measurement, the aneurysm diameter measured by CTA was greater than ultrasound (mean difference -1.70 mm, 95% confidence interval -2.45 to -0.96, p<0.001). |
4 |
| 83. Wieners G, Meyer F, Halloul Z, et al. Detection of type II endoleak after endovascular aortic repair: comparison between magnetic resonance angiography and blood-pool contrast agent and dual-phase computed tomography angiography. Cardiovasc Intervent Radiol. 33(6):1135-42, 2010 Dec. |
Observational-Dx |
32 patients with aortic aneurysms who had undergone EVAR |
To assess the diagnostic value of magnetic resonance angiography (MRA) with blood-pool contrast agent (gadofosveset) in the detection of type-II endoleak after endovascular aortic repair (EVAR). |
Median follow-up-time after EVAR was 22 months (range 4 to 59). Endoleak type II was detected by CTA in 12 of 32 patients (37.5%); MRA detected endoleak in all of these patients as well as in another 9 patients (n = 21, 65.6%), of whom the endoleaks in 6 patients showed an increasing diameter. Most endoleaks were detected in the steady-state phase (n = 14). The decrease in diameter of the aneurysmal sac was significantly greater in the patients without a visible endoleak that was visible on MRA (P = 0.004). In the overall estimation of diagnostic accuracy, MRA was judged superior to CTA in 66% of all examinations. |
3 |
| 84. Zaiem F, Almasri J, Tello M, Prokop LJ, Chaikof EL, Murad MH. A systematic review of surveillance after endovascular aortic repair. [Review]. J Vasc Surg. 67(1):320-331.e37, 2018 01. |
Review/Other-Dx |
6 meta-analyses and 52 observational studies (1099 candidates) |
To evaluate the optimal modality and frequency of surveillance after endovascular aortic repair (EVAR) in adult patients with abdominal aortic aneurysms. |
Of 1099 candidate references, we included 6 meta-analyses and 52 observational studies. Complication rates were common after EVAR, particularly in the first year. Magnetic resonance imaging had a higher detection rate of endoleaks than computed tomography angiography. Doppler ultrasound had lower diagnostic accuracy, whereas contrast-enhanced ultrasound was likely to be as sensitive as computed tomography angiography. The highest endoleak detection rates were in surveillance approaches that used combined tests. There were no studies that compared different surveillance intervals to determine optimal intervals; however, most studies reported detection rates of patient-important outcomes at 1, 6, 12, 24, 36, 48, and 60 months. Data were insufficient to provide comparative inferences about the best strategy to reduce the risk of patient-important outcomes, such as mortality, limb ischemia, rupture, and renal complications. |
4 |
| 85. Cohen EI, Weinreb DB, Siegelbaum RH, et al. Time-resolved MR angiography for the classification of endoleaks after endovascular aneurysm repair. J Magn Reson Imaging. 27(3):500-3, 2008 Mar. |
Observational-Dx |
31 patients who have undergone EVAR |
To evaluate the utility of time-resolved MR angiography (TR-MRA), compared with digital subtraction angiography (DSA), in the classification of endoleaks in patients who have undergone endovascular aneurysm repair (EVAR). |
Agreement between TR-MRA and DSA regarding endoleak classification occurred in 30 of 31 cases (97%). Discordant classification occurred in a case in which a Type II endoleak was misclassified as a Type III due to failure to visualize a lumbar vessel. |
4 |
| 86. van der Laan MJ, Bartels LW, Viergever MA, Blankensteijn JD. Computed tomography versus magnetic resonance imaging of endoleaks after EVAR. Eur J Vasc Endovasc Surg. 32(4):361-5, 2006 Oct. |
Observational-Dx |
28 patients |
To compare the sensitivity of MRI and CTA for endoleak detection and classification after EVAR. |
Using MRI and MRA techniques significantly more endoleaks (23/35) were detected than with CTA (11/35) (P=0.01, Chi-Square). CT could not determine the type of endoleak in 3 of the 11 endoleaks detected and was uncertain in one. MRI was uncertain about the type in 14 of the 23 endoleaks detected. All endoleaks visible on CT were visible by MRI as well. MRI techniques are more sensitive for the detection of endoleak after endovascular AAA repair than CT. |
3 |
| 87. Lookstein RA, Goldman J, Pukin L, Marin ML. Time-resolved magnetic resonance angiography as a noninvasive method to characterize endoleaks: initial results compared with conventional angiography. J Vasc Surg. 2004; 39(1):27-33. |
Observational-Dx |
12 patients |
To compare the findings of time-resolved MRA with conventional angiography for the characterization of endoleaks. |
Time-resolved MRA identified 7 patients with type I leaks, including four proximal and three distal. Four patients had type II leaks, including two arising from the inferior mesenteric artery and two from an iliolumbar artery. One patient had a type III leak. Conventional angiography confirmed the type of endoleak in all 12 patients. These initial results demonstrate time-resolved MRA to be an effective noninvasive method for classifying endoleaks. This technique may allow for screening of patients with endoleaks to identify those requiring urgent repair. |
2 |
| 88. Sakata M, Takehara Y, Katahashi K, et al. Hemodynamic Analysis of Endoleaks After Endovascular Abdominal Aortic Aneurysm Repair by Using 4-Dimensional Flow-Sensitive Magnetic Resonance Imaging. Circ J. 80(8):1715-25, 2016 Jul 25. |
Observational-Dx |
31 patients |
To assess the hemodynamics of different types of endoleaks (I-IV) using 4-dimensional flow-sensitive magnetic resonance imaging (4D-flow) . |
Magnetic resonance angiography, 4D-flow, and computed tomography angiography (CTA) were performed in 31 patients after nitinol-based stent-graft deployment. With 4D-flow, the 3D streamlines of endoleaks appear as integrated traces along the instantaneous velocity vector field that are color-coded according to the local velocity magnitude of the leak. The 4D-flow analysis identified endoleaks in 18 patients (58.1%), whereas CTA identified endoleaks in 13 patients (41.9%). The 4D-flow analysis created a characteristic image of each type of endoleak. Among patients with endoleaks, 4D-flow identified concomitant multiple endoleaks in 7 (39%) patients, and it further differentiated type II endoleaks from type IIa endoleaks (to-and-fro biphasic flow pattern from a branch vessel) and from type IIb endoleaks (monophasic flow pattern with a connection between the inflow and outflow branches). |
1 |
| 89. Salehi Ravesh M, Langguth P, Pfarr JA, et al. Non-contrast-enhanced magnetic resonance imaging for visualization and quantification of endovascular aortic prosthesis, their endoleaks and aneurysm sacs at 1.5T. Magnetic Resonance Imaging. 60:164-172, 2019 07. |
Observational-Dx |
8 patients with type I-V endoleaks |
To compare a non-contrast-enhanced MRI protocol (consist of four MRI methods) with DSA and CE-CTA for visualization and quantification of endovascular aortic prosthesis, their endoleaks and aneurysms. |
QISS-MRA provided good visualization of endoleaks and comparable quantification of aneurysm size with respect to CE-CTA and DSA. The 4D-flow MRI provided additional information about the wall shear stress, which could not be determined using DSA. In contrast to CE-CTA, T1- and T2-mapping provided detailed information about heterogeneous areas within an aneurysm sac. |
3 |
| 90. Fearn S, Lawrence-Brown MM, Semmens JB, Hartley D. Follow-up after endovascular aortic aneurysm repair: the plain radiograph has an essential role in surveillance. J Endovasc Ther 2003;10:894-901. |
Review/Other-Dx |
N/A |
To illustrate common endograft complications and the value of plain radiographs in their detection. |
No results provided |
4 |
| 91. Wolf YG, Johnson BL, Hill BB, Rubin GD, Fogarty TJ, Zarins CK. Duplex ultrasound scanning versus computed tomographic angiography for postoperative evaluation of endovascular abdominal aortic aneurysm repair. J Vasc Surg 2000;32:1142-8. |
Observational-Dx |
100 patients with AAA |
To compare duplex ultrasound scanning and computed tomographic (CT) angiography for postoperative imaging and surveillance after endovascular repair of abdominal aortic aneurysm (AAA). |
A total of 268 CT scans and 214 duplex scans were obtained at intervals of 1 to 30 months after endovascular aneurysm repair (mean follow-up interval, 9+/-7 months). All CT scans were technically adequate, and 198 (93%) of 214 duplex scans were technically adequate for the determination of aneurysm size, presence of endoleak, and graft patency. Concurrent (within 7 days of each other) scan pairs were obtained in 166 instances in 76 patients (1-6 per patient). The maximal transverse aneurysm sac diameter measured with both methods correlated closely (r = 0.93; P <.001) without a significant difference on paired analysis. In 92% of scans, measurements were within 5 mm of each other. Diagnosis of endoleak on both examinations correlated closely (P <.001), and compared with CT, duplex scanning had a sensitivity of 81%, a specificity of 95%, a positive predictive value of 94%, and a negative predictive value of 90%. Discordant results occurred in 8% of examinations, and in none of these was the endoleak close to the attachment sites or associated with aneurysm expansion. An endoleak was demonstrated on both tests in all eight patients who had an endoleak judged severe enough to warrant arteriography. Graft patency was documented in each instance, without discrepancy, with both modalities. |
1 |
| 92. Baliyan V, Verdini D, Meyersohn NM. Noninvasive aortic imaging. [Review]. Cardiovasc. diagn. ther.. 8(Suppl 1):S3-S18, 2018 Apr. |
Review/Other-Dx |
N/A |
To highlight recent advancements in non-invasive imaging and discuss the current role of different imaging tools in the management of aortic diseases. |
No results provided |
4 |
| 93. Arko FR, Filis KA, Siedel SA, et al. Intrasac flow velocities predict sealing of type II endoleaks after endovascular abdominal aortic aneurysm repair. J Vasc Surg. 2003; 37(1):8-15. |
Observational-Dx |
265 patients |
To determine whether intrasac spectral Doppler flow velocities can predict whether or not a type II endoleak will spontaneously seal and to relate intrasac flow to preoperative branch vessel anatomy. |
Spectral Doppler velocities were significantly lower in patients with sealed endoleaks compared with persistent endoleaks (75.5 +/- 78.8 cm/s vs 138.2 +/- 36.2 cm/s; P<.01). Patients with sealed endoleaks and low (<100 cm/s) intrasac Doppler velocities had significantly fewer patent inferior mesenteric arteries (43% vs 81%; P<.01), a smaller inferior mesenteric artery (5.6 +/- 1.8 mm vs 7.2 +/- 1.3 mm; P<.01), and fewer paired lumbar arteries (1.3 +/- 0.8 vs 2.4 +/- 0.6; P<.0001) compared with those with persistent endoleaks and high (>100 cm/s) intrasac flow velocities. Aneurysm diameter (-4.6 +/- 5.6 mm) and volume (-0.9 +/- 45.2 mL) decreased in patients with sealed endoleaks. Aneurysm diameter (1.8 +/- 4.9 mm) and volume (18.5 +/- 33.9 mL) increased slightly in patients with persistent endoleaks (P<.05). Intrasac Doppler velocities can be used to predict whether a type II endoleak will spontaneously seal. High-velocity type II endoleaks are related to preoperative large branch vessel diameter and number and are resistant to endovascular treatment. |
3 |
| 94. 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 |
