Dynamic Indicators That Impact the Outcomes of Thoracic Endovascular Aortic Repair in Complicated Type B Aortic Dissection
Publication date: Available online 22 January 2020Source: Journal of Vascular and Interventional RadiologyAuthor(s): Shuo Zhao, Hui Gu, Baojin Chen, Shifeng Yang, Zhaoping Cheng, Yanhua Duan, Yang Lin, Ximing WangAbstractPurposeTo investigate dynamic variables obtained from retrospective computed tomography angiography for ability to predict thoracic endovascular aortic repair (TEVAR) outcomes in patients with complicated type B aortic dissection (cTBAD).Materials and MethodsSeventy-nine patients with cTBAD who received TEVAR from March 2009 to June 2018 were retrospectively enrolled. Relative true lumen area (r-TLA) was computed at the level of tracheal bifurcation every 5% of all R-R intervals. Parameters that reflect the state of intimal motion were evaluated, including difference between maximum and minimum r-TLA (D-TLA) and true lumen collapse. The endpoints comprised early (≤ 30 days) and late (> 30 days) outcomes after intervention.ResultsOverall early mortality rate was 13.9% (11/79), and early adverse events rate was 24.1% (19/79). Patients who received TEVAR within 2 days of symptom onset demonstrated the worst outcomes. A longer time of r-TLA
CT angiography offers excellent anatomic detail necessary for vascular procedural planning including endovascular aneurysm repair (EVAR). However, patients with renal insufficiency are at risk for acute renal failure due to iodinated contrast administration. Catheter-directed CT angiography is a technique in which dilute iodinated contrast is injected into an intra-aortic pigtail catheter during the CT scan. The purpose of this study was to evaluate the safety and efficacy of this technique.
AbstractIntroductionTo identify patients with aneurysmal degeneration of the native aorta following type A aortic dissection (TAAD), reproducible serial measurements of aortic dimensions are critical. We used a systematic workflow for measuring aortic geometry following TAAD, using computed tomography angiography data, and test its reproducibility.MethodsThe workflow for aortic measurements included centerline generation, luminal diameter, and area measurement at six anatomically defined locations along the aorta and luminal volumetric measurements in the descending aorta. Two independent observers measured the aortic geom...
We present the first case with history of repaired coarctation with multiple spontaneous intercostal artery aneurysmal rupture.
We present the first case with history of repaired coarctation with multiple spontaneous intercostal artery aneurysmal rupture. PMID: 32035043 [PubMed - as supplied by publisher]
The objective of this work was to perform image-based classification of abdominal aortic aneurysms (AAA) based on their demographic, geometric, and biomechanical attributes. We retrospectively reviewed existing demographics and abdominal computed tomography angiography images of 100 asymptomatic and 50 symptomatic AAA patients who received an elective or emergent repair, respectively, within 1-6 months of their last follow up. An in-house script developed within the MATLAB computational platform was used to segment the clinical images, calculate 53 descriptors of AAA geometry, and generate volume meshes suitable for finite...
CONCLUSION: Emergency percutaneous endovascular repair is a less invasive and effective approach for the treatment of traumatic blunt aortic injuries. Long-term result remains to be further followed. PMID: 32057561 [PubMed - as supplied by publisher]
ConclusionInterarterial segment stenting appears feasible and safe. More important population and longer follow-up are needed to include this approach in a future management algorithm for patients with ANOCOR.
CONCLUSIONS: The current body of evidence suggests that intra-operative CT is superior to completion angiography at detecting clinically important EVAR complications and incurs a lower total radiation dose with no added risk of contrast-induced renal impairment. Further research directly comparing the two modalities in the same cohort is required to determine sensitivity for individual complications. PMID: 31904305 [PubMed - as supplied by publisher]
Abstract OBJECTIVE: The aim of this study was to evaluate aortic remodelling and associated complications in patients treated by thoracic endovascular aneurysm repair (TEVAR) for blunt traumatic aortic injuries (BTAI). METHODS: This was a retrospective, observational, multicentre study. Remodelling was considered as aortic diameter variations of>2 mm and distal graft and aortic axis angle modification measured by computed tomography angiography (CTA). The predefined levels of measurement were the proximal end of the graft (D1: landing in zone [LZ] 2; D2: LZ 3); distal end (D3); and control measurement...
The objective of this study was to evaluate the efficacy of treating type II endoleaks (T2Ls) after aortic endovascular repair with image guidance translumbar puncture using intraoperative cone beam computed tomography with preprocedure computed tomography angiography fusion in hybrid operating rooms.