A CURRENT ROLE OF ENDOVASCULAR TECHNIQUES IN THE DIAGNOSIS AND TREATMENT OF PATIENTS WITH ACUTE AORTIC PATHOLOGY
Abstract
OBJECTIVES. A timely and accurate diagnosis of acute aortic disease is a prerequisite for a successful surgical treatment. Medical imaging techniques vary in their diagnostic capacity.
PURPOSE. The purpose was to assess the current role of endovascular techniques among other diagnostic and treatment modalities for patients with an acute aortic pathology.
MATERIAL AND METHODS. The results of endovascular diagnostic investigations performed in 472 patients with aortic pathology have been reviewed.
RESULTS. Detection of aorta pathology made 89.6% for aortic aneurysms, 14.1% for aneurysm ruptures, 93.1% for aortic dissection, and 100% for aortic injury. Dissections extended to the aortic branches were identified completely in 41.2 % of cases, and partially indentified in 17.6 %. Endovascular examinations allowed a more accurate evaluation of the aortic branches. Angiography measurements did not reflect an exact size of the aneurysm.
CONCLUSION. The angiography is less sensitive method than bolus contrast-enhanced CT and Doppler ultrasonography and thus should be used only in the cases of suspected aortic-visceral fistulae, to assess the involvement of the aortic branches, the coronary arteryies, and the arteries contributing to spine perfusion, and also in the cases of suspected aortic injury in equivocal CT findings. Angiography should be used at the final stage of the diagnostic work-up in unclear cases and becomes more commonly considered as an endovascular surgical technique for stent-graft implantation, including that in the cases of acute aortic pathology.
About the Authors
S. A. Prozorov
Sklifosovsky Research Institute for Emergency Medicine of Health Department of Moscow, Moscow
Russian Federation
Russian Federation
G. E. Belozerov
Sklifosovsky Research Institute for Emergency Medicine of Health Department of Moscow, Moscow
Russian Federation
Russian Federation
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Review
For citations:
Prozorov S.A., Belozerov G.E. A CURRENT ROLE OF ENDOVASCULAR TECHNIQUES IN THE DIAGNOSIS AND TREATMENT OF PATIENTS WITH ACUTE AORTIC PATHOLOGY. Russian Sklifosovsky Journal "Emergency Medical Care". 2013;(1):46-49. (In Russ.)
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