IP067. Outcomes of Surgeon-Modified Fenestrated Endografts in the Treatment of High-Risk and Acute Aortic Disease

AbstractAt present time, both CT and MRI are valuable techniques in the study of the thoracic aorta. Nowadays, CT represents the most widely employed technique for the study of the thoracic aorta. The new generation CTs show sensitivities up to 100% and specificities of 98-99%. Sixteen and wider row detectors provide isotropic pixels, mandatory for the ineludible longitudinal reconstruction. The main limits are related to the X-ray dose expoure and the use of iodinated contrast media. MRI has great potential in the study of the thoracic aorta. Nevertheless, if compared to CT, acquisition times remain longer and movement artifact susceptibility higher. The main MRI disadvantages are claustrophobia, presence of ferromagnetic implants, pacemakers, longer acquisition times with respect to CT, inability to use contrast media in cases of renal insufficiency, lower spatial resolution and less availability than CT. CT is preferred in the acute aortic disease. Nevertheless, since it requires iodinated contrast media and X-ray exposure, it may be adequately replaced by MRI in the follow up of aortic diseases. The main limitation of MRI, however, is related to the scarce visibility of stents and calcifications.

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D-dimer serum levels in a case of type B aortic dissection. A rapid test for the early diagnosis of acute aortic disease?

Journal of Cardiovascular Medicine ◽

10.2459/01.jcm.0000215276.62767.c6 ◽

2006 ◽

Vol 7 (3) ◽

pp. 216-218 ◽

Cited By ~ 4

Author(s):

Antonio DʼAloia ◽

Pompilio Faggiano ◽

Loretta Brentana ◽

Livio Dei Cas

Keyword(s):

Early Diagnosis ◽

Aortic Dissection ◽

Rapid Test ◽

Serum Levels ◽

Aortic Disease ◽

Type B ◽

Type B Aortic Dissection ◽

Acute Aortic Disease ◽

D Dimer

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Gender differences in outcomes after aortic aneurysm surgery should foster further research to improve screening and prevention programmes

European Journal of Preventive Cardiology ◽

10.1177/2047487318759121 ◽

2018 ◽

Vol 25 (1_suppl) ◽

pp. 32-41 ◽

Cited By ~ 9

Author(s):

Francesco Nicolini ◽

Antonella Vezzani ◽

Francesco Corradi ◽

Riccardo Gherli ◽

Filippo Benassi ◽

...

Keyword(s):

Gender Differences ◽

High Risk ◽

Aortic Aneurysm ◽

Aortic Surgery ◽

Aortic Disease ◽

Aortic Aneurysms ◽

High Dose ◽

Female Patients ◽

Prevention Programmes ◽

Screening And Prevention

Background Gender-related biases in outcomes after thoracic aortic surgery are an important factor to consider in the prevention of potential complications related to aortic diseases and in the analysis of surgical results. Methods The aim of this study is to provide an up-to-date review of gender-related differences in the epidemiology, specific risk factors, outcome, and screening and prevention programmes in aortic aneurysms. Results Female patients affected by aortic disease still have worse outcomes and higher early and late mortality than men. It is difficult to plan new specific strategies to improve outcomes in women undergoing major aortic surgery, given that the true explanations for their poorer outcomes are as yet not clearly identified. Some authors recommend further investigation of hormonal or molecular explanations for the sex differences in aortic disease. Others stress the need for quality improvement projects to quantify the preoperative risk in high-risk populations using non-invasive tests such as cardiopulmonary exercise testing. Conclusions The treatment of patients classified as high risk could thus be optimised before surgery becomes necessary by means of numerous strategies, such as the administration of high-dose statin therapy, antiplatelet treatment, optimal control of hypertension, lifestyle improvement with smoking cessation, weight loss and careful control of diabetes. Future efforts are needed to understand better the gender differences in the diagnosis, management and outcome of aortic aneurysm disease, and for appropriate and modern management of female patients.

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