The diagnosis of thoracic aortic dissection by noninvasive imaging procedures

Article Abstract:

The noninvasive imaging techniques of transesophageal echocardiography (TEE) and magnetic resonance imaging (MRI) may be preferred to aortography in diagnosing patients with suspected dissection of the thoracic aorta. Aortic dissection is a splitting of the arterial wall and is a serious condition requiring immediate diagnosis. Unlike the noninvasive measures, aortography requires injection of an opaque substance before x-rays can be taken. One hundred ten patients with suspected aortic dissection underwent at least two screening procedures - x-ray computed tomography (CT), transthoracic echocardiography (TTE), TEE or MRI - and diagnosis was compared with results from intraoperative inspection, contrast angiography or autopsy. MRI and TTE were both highly sensitive, with few misses or false positives, and neither x-ray CT nor aortography provided any additional information. Researchers recommend using MRI, which provides the most detailed information in stable patients and using TEE in patients who cannot be moved.

Magnetic resonance imaging, Diagnostic imaging, Transesophageal echocardiography

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Nonsurgical reconstruction of thoracic aortic dissection by stent-graft placement

Article Abstract:

Nonsurgical reconstruction of an dissecting aortic aneurysm with a stent appears to be better than surgery. A dissecting aortic aneurysm occurs when the aorta begins to balloon out so far that a tear appears in the aorta. Researchers randomly assigned 24 people with a dissecting aneurysm to be treated surgically or with a stent that was guided up to the heart on a catheter inserted into a leg artery. A stent is a cylindrical device that can keep arteries open. Only seven surgical patients recovered, compared to all 12 who received a stent. There were four deaths in the surgery group but none in the stent group.

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Endovascular stent-graft placement for the treatment of acute aortic dissection

Article Abstract:

The use of stents may be preferable to surgery for treating a dissecting aortic aneurysm. This condition occurs when the aorta begins to balloon out so far that a crack develops in the aorta. A stent is a cylindrical device that can keep the aorta from opening further. Researchers inserted the stent on a catheter threaded through a leg artery in 19 patients with a dissecting aortic aneurysm. The technique was successful in all 19 patients. Three of the patients died within 30 days of the procedure.

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