| Acute type A aortic dissection intimal tears by 64-slice computed tomography: a role for endovascular stent-grafting? | |
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MedLine Citation:
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PMID: 22820738 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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AIM: The goal of this study was to identify physical characteristics of primary intimal tears in patients arriving to the hospital alive with acute type A aortic dissection using 64-multislice computerized tomography (MSCT) in order to determine anatomic feasibility of endovascular stent-grafting (ESG) for future treatment. METHODS: Radiology database was screened for acute type A aortic dissection since the time of acquisition of the 64-slice CT scanner and cross-referenced with surgical database. Seventeen patients met inclusion criteria. Images were reviewed for number, location, and size of intimal tears and aortic dimensions. Potential obstacles for ESG were determined. RESULTS: Ascending aorta (29%) and sinotubular junction (29%) were the most frequent regions where intimal tears originated. Location of intimal tears in nearly 75% of patients was inappropriate for ESG, and 94% of patients did not have sufficient proximal or distal landing zone required for secure fixation. Only 71% of patients underwent surgical aortic dissection repair after imaging and 86% of entry tears detected on MSCT were confirmed on intraoperative documentation. Only one patient would have met all technical criteria for ESG using currently available devices. CONCLUSION: Location of intimal tear, aortic valve insufficiency, aortic diameter>38mm are major factors limiting use of ESG for acute type A dissection. Available stents used to treat type B aortic dissection do not address anatomic constraints present in type A aortic dissection in the majority of cases, such that development of new devices would be required. |
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Authors:
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N Jaussaud; S Chitsaz; A Meadows; M Wintermark; N Cambronero; A N Azadani; D A Saloner; T A Chuter; E E Tseng |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-7-23 |
Journal Detail:
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Title: The Journal of cardiovascular surgery Volume: - ISSN: 0021-9509 ISO Abbreviation: - Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-7-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0066127 Medline TA: J Cardiovasc Surg (Torino) Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Division of Cardiothoracic Surgery, Department of Surgery, University of California at San Francisco Medical Centerand San Francisco Veterans Affairs Medical Center, San Francisco, Ca, USA - Elaine.Tseng@ucsfmedctr.org. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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