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Updated: Jun 30, 2026
09:55
Three-Dimensional Imaging of Aortic Tissues in Atherosclerosis
Published on: October 25, 2024
[Acute aortic dissection: diagnostic usefulness of D-dimer]
Yvan Fournier1, Paul-André Moix, Olivier Hugli
1Service de médecine interne, CHUV, 1011 Lausanne. Yvan.Fournier@chuv.ch
Revue Medicale Suisse
|September 20, 2008
Summary
Diagnosing acute aortic dissection (AAD) is challenging. While D-dimer tests show promise in ruling out AAD, their current use is limited by study design flaws and test variability.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Emergency Medicine
Context:
- Acute aortic dissection (AAD) presents a diagnostic challenge due to its rarity and severe outcomes.
- Clinical parameters, ECG, and chest X-rays lack sufficient accuracy for definitive AAD diagnosis or exclusion.
- Established diagnostic tools like CT angiography, echocardiography, and MRI are invasive and carry risks.
Purpose:
- To evaluate the utility of D-dimer testing in ruling out acute aortic dissection (AAD).
- To assess the limitations and potential of D-dimer as a diagnostic marker for AAD.
Summary:
- D-dimer testing, particularly with normal levels, has shown potential negative predictive value for ruling out AAD in some studies.
- However, significant heterogeneity in D-dimer assays, varying cutoff levels (100-900 microg/l), and study design limitations challenge its reliable application.
- The absence of a standardized diagnostic strategy further complicates the use of D-dimer as a sole test for excluding AAD.
Impact:
- Highlights the need for rigorous validation and standardized protocols before incorporating D-dimer into routine AAD diagnostic pathways.
- Suggests that current evidence does not support the use of D-dimer as a standalone test to rule out AAD.
- Emphasizes the continued reliance on advanced imaging techniques for definitive AAD diagnosis despite their associated risks.
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