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Registry of Aortic Diseases to Model Adverse Events and Progression (ROADMAP) in Uncomplicated Type B Aortic
Domenico Mastrodicasa1, Martin J Willemink1, Valery L Turner1
1Center for Academic Medicine, Department of Radiology (D.M., M.J.W., V.L.T., V.H., M.C., A.M.S., K.B., D.F.), Stanford Cardiovascular Institute (D.M., M.P.F., D.F.), and Department of Cardiothoracic Surgery (D.C.M., M.P.F.), Stanford University School of Medicine, 453 Quarry Rd, MC 5659, Palo Alto, CA 94304-5659; Departments of Medical Imaging (K.H.) and Surgery (M.O.), Toronto General Hospital, University of Toronto, Toronto, Canada; Department of Radiology (D.O.T.) and Department of Cardiothoracic and Vascular Surgery (R.O.A.), McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Tex; Department of Radiology, Massachusetts General Hospital, Boston, Mass (S.H.); Departments of Radiology (N.S.B.) and Cardiac Surgery (B.Y.), University of Michigan, Ann Arbor, Mich; Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pa (J.M.L.); Division of Cardiac Surgery, University of Maryland, Baltimore, Md (T.G.G.); Departments of Cardiac Surgery (D.P., G.F.) and Radiology (L.L.), IRCCS Azienda Ospedaliero-Universitaria di Bologna S. Orsola Hospital, Bologna, Italy; Department of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland (R.H., H.A.); Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (A.E.S.); Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, NC (E.P.C.); and Department of Clinical Epidemiology and Medical Technology Assessment (S.M.J.v.K.) and Department of Surgery (G.W.H.S.), Maastricht University Medical Center, Maastricht, the Netherlands.
Purpose:
To describe the design and methodological approach of a multicenter, retrospective study to externally validate a clinical and imaging-based model for predicting the risk of late adverse events in patients with initially uncomplicated type B aortic dissection (uTBAD).
Materials And Methods:
The Registry of Aortic Diseases to Model Adverse Events and Progression (ROADMAP) is a collaboration between 10 academic aortic centers in North America and Europe. Two centers have previously developed and internally validated a recently developed risk prediction model. Clinical and imaging data from eight ROADMAP centers will be used for external validation. Patients with uTBAD who survived the initial hospitalization between January 1, 2001, and December 31, 2013, with follow-up until 2020, will be retrospectively identified. Clinical and imaging data from the index hospitalization and all follow-up encounters will be collected at each center and transferred to the coordinating center for analysis. Baseline and follow-up CT scans will be evaluated by cardiovascular imaging experts using a standardized technique.
Results:
The primary end point is the occurrence of late adverse events, defined as aneurysm formation (≥6 cm), rapid expansion of the aorta (≥1 cm/y), fatal or nonfatal aortic rupture, new refractory pain, uncontrollable hypertension, and organ or limb malperfusion. The previously derived multivariable model will be externally validated by using Cox proportional hazards regression modeling.
Conclusion:
This study will show whether a recent clinical and imaging-based risk prediction model for patients with uTBAD can be generalized to a larger population, which is an important step toward individualized risk stratification and therapy.Keywords: CT Angiography, Vascular, Aorta, Dissection, Outcomes Analysis, Aortic Dissection, MRI, TEVAR© RSNA, 2022See also the commentary by Rajiah in this issue.
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