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The IRAD and beyond: what have we unravelled so far?

Xun Yuan1, Andreas Mitsis1, Yida Tang2

  • 1Cardiology and Aortic Centre, Royal Brompton and Harefield NHS Trust and Imperial College, Sydney Street, London, SW3 6NP, UK.

General Thoracic and Cardiovascular Surgery
|September 8, 2017
PubMed

Insights

The International Registry of Acute Aortic Dissection (IRAD) has improved diagnosis and management of aortic dissection. Advances in imaging and treatment have led to better outcomes and increased survival rates for patients.

Area of Science:

  • Cardiovascular Medicine
  • Medical Informatics

Background:

  • Acute aortic dissection presents significant diagnostic and management challenges, leading to high morbidity and mortality.
  • The International Registry of Acute Aortic Dissection (IRAD) was founded in 1996 to enhance understanding and care for this condition.

Purpose of the Study:

  • To analyze the evolution of diagnostic and therapeutic strategies for acute aortic dissection over two decades.
  • To assess the impact of the IRAD registry on improving patient outcomes.

Main Methods:

  • Analysis of data collected by the International Registry of Acute Aortic Dissection (IRAD) since its inception.
  • Review of changes in diagnostic modalities, particularly computed tomography, and treatment approaches (surgery, endovascular therapy).

Main Results:

  • While clinical presentation remains consistent, computed tomography has become a standard diagnostic tool, improving diagnostic accuracy.
  • Increased utilization of appropriate interventions, including surgery for Type A and endovascular therapy for Type B dissections.
  • Improvements in diagnostic work-up and therapeutic care have reduced undertreatment and increased patient survival.

Conclusions:

  • The IRAD registry has been instrumental in advancing the understanding and management of acute aortic dissection.
  • Contemporary diagnostic and therapeutic advancements have significantly improved patient survival rates for acute aortic dissection.

Keywords:
Aortic dissectionBiomarkerCardiovascular surgeryEndovascular managementImaging techniques

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