Modern diagnostics for type B aortic dissection

T. Donati,R.E. Clough,J. Wilson,T. Kölbel

doi:10.1007/s00772-015-0078-6

T. Donati, R.E. Clough + Show 2 more

Open Access

https://doi.org/10.1007/s00772-015-0078-6

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Journal: Gefässchirurgie	Publication Date: Oct 1, 2015
Citations: 10	License type: CC BY 4.0

Affiliation: Guy's and St Thomas' NHS Foundation Trust

Abstract

BackgroundUndifferentiated chest pain is one of the most common complaints in the acute care setting. Type B aortic dissection is an important cause of chest pain and a complex clinical entity, which carries significant morbidity and mortality and requires accurate clinical and radiological evaluation.MethodsImaging technologies have become an irreplaceable tool to establish the diagnosis of aortic dissection and to plan treatment strategies. Computed tomography is an important component in this process, replacing catheter-based angiography as the most commonly used preoperative and postoperative imaging modality for the thoracic aorta. The use of functional imaging methods, such as magnetic resonance imaging and echocardiography is evolving. These methods are able to provide the clinically relevant anatomical, hemodynamic and biomechanical information that is necessary for accurate diagnosis, risk stratification and patient selection for treatment.ConclusionAdvanced image acquisition equipment and expertise are increasingly available in a growing number of institutions and as a consequence, existing strategies for the management of type B dissection are rapidly evolving.

Highlights

Undifferentiated chest pain is one of the most common complaints in the acute care setting, accounting for over 5 million emergency department visits in the USA each year [1]
Type B aortic dissection is an important cause of chest pain and a complex clinical entity, which carries significant morbidity and mortality and requires accurate clinical and radiological evaluation
Computed tomography is an important component in this process, replacing catheter-based angiography as the most commonly used preoperative and postoperative imaging modality for the thoracic aorta

Summary

Introduction

The disease is dynamic, in this phase and changeable behavior of the intimal flap, extension of the dissection and expansion of the false lumen are possible. This can lead to contained or free rupture of the aorta, organ and/or limb malperfusion, early false lumen expansion, resistant hypertension and uncontrollable pain [6]. Dissections with these features are considered to be complicated and endovascular intervention is indicated.

Limitations

Conclusion

Compliance with ethical guidelines