1) What are some clinical indications for acute aortic imaging. 2) What are some CT parameters that can aid in various diagnosis? 3) What are some of common complications seen in TEVAR and EVAR? 4) What are the important measurements and vessel variants that help guide surgical approach. 5) New suggestions for type B management. 6) What are some imaging problems and pitfall and some methods to assist. 7) Briefly discuss TAVR acquisition.
The acute aorta is part of a syndrome of diseases affecting the aorta with significant overlap of findings and clinical presentations. Clinically the diagnosis is difficult as there is overlap between patients with suspected coronary disease, pulmonary embolism and acute aortic syndrome. In the past several years, minimally invasive surgery with Thoracic Endovascular Aortic Repair (TEVAR) or Endovascular Aortic Repair (EVAR) have become increasingly popular. The images choices include gated vs non gated studies, non-contrast imaging, and delayed imaging. The literature is mixed on how and when to use these modalities. The complications of these procedures is often complex and subtle as well. Knowledge of these vascular complications is imperative for patient management. In addition, these patients often have significant atherosclerotic disease elsewhere that might be limiting factors for stent placement, including renal insufficiency. Newer scanners and imaging techniques can reduce radiation dose, and limit the amount of contrast delivery to preserve renal function while preserving image quality. TAVR is an example of another minimally invasive technique gaining popularity that has imaging challenges. Again, newer scanning techniques with limited contrast delivery can provide excellent image quality while limiting radiation dose and preserving renal function.
Wilcox, A,
TEVAR/EVAR- Pre, Post and Periprocedural Evaluation. Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL.
http://archive.rsna.org/2014/9001496.html
