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Imaging for acute aortic syndromes
  1. Brett J Carroll1,
  2. Marc L Schermerhorn2,
  3. Warren J Manning1,3
  1. 1 Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  2. 2 Division of Vascular Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  3. 3 Radiology, Beth Israel Deaconness Medical Center, Boston, Massachusetts, USA
  1. Correspondence to Dr Brett J Carroll, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; bcarrol2{at}bidmc.harvard.edu

Abstract

Acute aortic syndromes (AAS) represent a spectrum of disorders with a common theme of disruption in aortic integrity. AAS are associated with high morbidity and mortality and warrant emergent medical or surgical intervention as delayed treatment is associated with worse outcomes. There are multiple advanced imaging modalities for the diagnosis and complimentary assessment of AAS, each with advantages and limitations. CT angiography remains the imaging modality of choice for diagnosis in the overwhelming majority of patients as it is rapidly acquired and widely available; however, transoesophageal echocardiogram also offers excellent diagnostic accuracy in addition to complimentary data for surgical repair in those with type A dissection. Transthoracic echocardiography and magnetic resonance angiography can also be valuable in select patients. Imaging is increasingly important for risk stratification in the subacute and chronic phases of AAS. Additionally, imaging is vital for planning of interventions in both acute and delayed intervention. Endovascular treatment options are used with increasing frequency—multimodality imaging during the procedure allows for optimisation of these increasingly complex procedures.

  • aortic dissection or intramural haematoma
  • echocardiography

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Footnotes

  • Contributors BJC, MLS and WJM were involved in the drafting, writing and revision of this review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests MLS has received consulting fees from Cook Medical, Medtronic and Endologix.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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