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[I.v. DSA in the diagnosis and follow-up of thoracic aortic dissection]
Insights
Intravenous digital subtraction angiography (IV DSA) reliably diagnoses type B aortic dissection and post-surgery complications. However, it is less reliable for type A dissections, especially with severe aortic insufficiency or cardiac tamponade.
Area of Science:
- Cardiovascular Imaging
- Vascular Surgery
Background:
- Aortic dissection is a life-threatening condition requiring accurate diagnosis.
- Intravenous digital subtraction angiography (IV DSA) is a potential imaging modality for evaluating aortic dissection.
Purpose of the Study:
- To evaluate the diagnostic accuracy and reliability of IV DSA in patients with suspected thoracic aortic dissection and post-operative surveillance.
Main Methods:
- IV DSA was performed in 53 patients with suspected thoracic aortic dissection and 13 post-operative patients.
- Diagnostic accuracy was assessed by comparing IV DSA findings with definitive diagnoses.
Main Results:
- IV DSA excluded dissection in 36 patients and correctly diagnosed dissection in 14 out of 17 cases.
- All 11 type B dissections were accurately diagnosed.
- Only 3 out of 6 type A dissections were adequately visualized.
- IV DSA was reliable for type B dissections and post-operative assessment but less so for type A dissections with complications.
Conclusions:
- IV DSA is a reliable tool for diagnosing type B aortic dissection and monitoring post-surgical changes.
- Diagnostic accuracy of IV DSA for type A aortic dissection is limited, particularly in cases with hemodynamic compromise.
Abstract:
Intravenous DSA was performed in 53 patients with suspected dissection of the thoracic aorta and in 13 patients following surgery for aortic dissection. In 36 patients, the suspected diagnosis could be excluded definitely and, in 14 cases out of 17, a dissection was correctly diagnosed. All 11 type B dissections were correctly diagnosed. Of six type A dissections, only three were adequately demonstrated by IV DSA. In type B dissections, IV DSA is reliable, but in type A dissection with massive aortic insufficiency or pericardial tamponade the findings are not reliable. In all 13 patients who had surgery for dissection, IV DSA proved suitable for showing the anastomosis and progress of the disease.