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Ueda T, Hayashi H, Ando T, Iwata K, Saito H, Kumita SI. Computed Tomography Attenuation Values of the High-Attenuating Crescent Sign Can Discriminate Between Rupture, Impending Rupture, and Non-Rupture of Aortic Aneurysms. Circ J 2021; 85:2184-2190. [PMID: 34707030 DOI: 10.1253/circj.cj-21-0541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Although the high-attenuating crescent (HAC) sign can indicate aortic aneurysm (AA) impending rupture, the relation of its computed tomography (CT) value to the aneurysmal status remains unclear. This study compared the HAC sign CT-attenuation values among rupture, impending rupture, and non-rupture AA cases.Methods and Results:This included 76 patients (mean age: 77.0 years) diagnosed with HAC sign-associated AA between January 2005 and July 2015. The CT-attenuation values of the HAC sign (H) and aortic lumen (A) using region-of-interest methodology were measured and the H/A ratio was calculated. The study classified patients into the rupture group (R-G, n=36), impending rupture group (IR-G, n=16), and non-rupture group (NR-G, n=24); the H and the H/A ratio were compared among them. Additionally, the H and the H/A ratio cut-offs between the IR-G and NR-G groups were evaluated. The H and the H/A ratio were significantly higher in the R-G and IR-G than in the NR-G (both P<0.001); the H/A ratio was significantly higher in the R-G than in the IR-G (P=0.038). The optimal cut-off for H between the IR-G and NR-G was 50.3 Hounsfield units (area under the curve [AUC]=0.875; sensitivity=87.5%; specificity=87.5%), and that for the H/A ratio was 1.3 (AUC=0.909; sensitivity=91.7%; specificity=87.5%). CONCLUSIONS Among patients with AA, the H and the H/A ratio were significantly higher in cases of rupture and impending rupture than in those of non-rupture.
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Affiliation(s)
- Tatsuo Ueda
- Department of Radiology, Nippon Medical School Hospital
| | | | - Takahiro Ando
- Department of Radiology, Nippon Medical School Hospital
| | - Kotomi Iwata
- Department of Radiology, Nippon Medical School Hospital
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Antunes BFF, Tachibana A, Mendes CDA, Lembrança L, Silva MJ, Teivelis MP, Wolosker N. Signs of impending rupture in abdominal aortic and iliac artery aneurysms by computed tomography: Outcomes in 41 patients. Clinics (Sao Paulo) 2021; 76:e2455. [PMID: 33681945 PMCID: PMC7920398 DOI: 10.6061/clinics/2021/e2455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/29/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES This study aimed to determine the prevalence of signs of impending rupture (SIR) in asymptomatic patients with abdominal aortic and iliac artery aneurysms, and to evaluate whether these signs were associated with rupture in asymptomatic patients. METHODS This was a retrospective study of patients with abdominal aortic and iliac artery aneurysms identified on computed tomography (CT) over a 10-year period in a single center. The CT scans were reviewed by two reviewers, and patients with SIR were assigned to one of three groups: (1) early symptomatic (ES), (2) late symptomatic (LS), and (3) always asymptomatic (AA). The four main SIR described in the literature were investigated: 1) crescent sign, 2) focal wall discontinuity of circumferential calcifications, 3) aortic bulges or blebs, and 4) aortic draping. RESULTS From a total of 759 aortic and iliac aneurysm reports on 2226 CT scans, we identified 41 patients with at least one SIR, and a prevalence of 4.14% in asymptomatic patients. Focal wall discontinuity of circumferential calcifications was the most common sign, and it was present in 46.3% of these patients (19/41); among these, 26 were repaired (ES: 9, LS: 2, AA: 15). Eleven asymptomatic patients underwent follow-up CT. The aneurysm increased in size in 6 of the 11 (54.5%) patients, and three ruptured (all with discontinuity of calcifications), one of which had no increase in diameter. CONCLUSIONS The presence of focal wall discontinuity of circumferential calcifications was the most common SIR. There was a prevalence of all signs in less than 5% of asymptomatic patients. In unrepaired patients, the signs could be observed on follow-up CT scans with an increase in aneurysm size, indicating that the presence of SIR alone in the absence of other clinical factors or aneurysm characteristics is an insufficient indication for surgery.
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Affiliation(s)
- Bruno Fabricio Feio Antunes
- Departamento de Cirurgia Vascular, Hospital Israelita Albert Einstein, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
| | - Adriano Tachibana
- Departamento de Radiologia, Hospital Israelita Albert Einstein, Sao Paulo, SP, BR
| | | | - Lucas Lembrança
- Departamento de Cirurgia Vascular, Hospital Israelita Albert Einstein, Sao Paulo, SP, BR
| | - Marcela Juliano Silva
- Departamento de Cirurgia Vascular, Hospital Israelita Albert Einstein, Sao Paulo, SP, BR
| | | | - Nelson Wolosker
- Departamento de Cirurgia Vascular, Hospital Israelita Albert Einstein, Sao Paulo, SP, BR
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Patel TV, Canario DAH, Isaacson AJ, Mauro DM. Vascular Etiologies of the Acute Abdomen. Semin Roentgenol 2020; 55:417-426. [PMID: 33220787 DOI: 10.1053/j.ro.2020.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Tirth V Patel
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC
| | | | - Ari J Isaacson
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC
| | - David M Mauro
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC.
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Hu SY, Hsieh MS, Chang YT, Huang CC, Tsai CA, Tsai CL, Hsu CY, Shen CH, Chang YZ. Clinical features, management, and outcome of iliopsoas abscess associated with cardiovascular disorders: a hospital-based observational case series study. BMC Musculoskelet Disord 2019; 20:474. [PMID: 31653245 PMCID: PMC6815067 DOI: 10.1186/s12891-019-2798-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 08/29/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Iliopsoas abscess (IPA) is a rare clinical entity and is difficult to diagnose due to its insidious onset and nonspecific symptoms. The association between IPA and cardiovascular disorders (CVD) has been rarely reported. Computed tomographic (CT) scan can provide a definitive diagnosis of IPA and associated foci of adjacent structures. IPA is a life-threatening condition, especially when associated with CVD. MATERIALS AND METHODS We conducted a hospital-based observational study of IPA associated with CVD. Data were collected from the electronic clinical database of Taichung Veterans General Hospital (1520-bed tertiary referral hospital in central Taiwan) between July 2007 and December 2017. The diagnosis of IPA associated with CVD was confirmed by classical findings on CT and transesophageal echocardiography with compatible clinical presentation and cultures from pus/tissue and blood. RESULTS Fifteen patients of IPA associated with CVD were studied. They included 12 males (80%) and 3 females (20%), with a mean age 63.2 ± 16.9 years (31-85 years). CVD included stent-graft/endograft infection of abdominal aortic aneurysm (AAA) (40%), primary mycotic AAA (33.3%), and infective endocarditis (26.7%). Staphylococcus aureus is the most common microorganism in pus/tissue cultures (n = 3, 37.5%) and in blood cultures (n = 6, 40%). The average length of hospital stay was 33.1 ± 20.5 days (range, 3-81 days; median, 33 days). Hospital stay lasted 42.6 ± 19.2 days in the survival group and 19.0 ± 14.1 days (P = 0.018) in the non-survival group. Incidence of patients staying in the intensive care unit (ICU) with intubation > 3 days was 33% in the survival group and 100% (P = 0.028) in the non-survival group. Intra-hospital mortality rate was 40%. Poor prognostic factors in the non-survival group were hypoalbuminemia, hyponatremia, involved disc/vertebral body and/or epidural abscess, and ICU stay with intubation > 3 days. Cumulative survival rate was 25% under conservative treatments and 66.3% under aggressive treatments (P = 0.038). CONCLUSION Due to high mortality rates, clinicians should keep a high suspicion index for IPA associated with CVD through clinical presentation, physical examination, and imaging study. Timely empiric antibiotics for common bacteria, drainage for IPA, endovascular repair, or vascular reconstruction by graft replacement or bypass with intensive care should be mandatory to shorten the hospital stay, reduce medical costs, and lower mortality rate.
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Affiliation(s)
- Sung-Yuan Hu
- Institute of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd, Taichung City, 40201 Taiwan
- School of Medicine, Chung Shan Medical University, Taichung City, Taiwan
- Department of Emergency Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung City, 40705 Taiwan
- Department of Nursing, College of Health, National Taichung University of Technology and Science, Taichung City, Taiwan
- Department of Nursing, Central Taichung University of Technology and Science, Taichung City, Taiwan
- School of Medicine, National Yang-Min University, Taipei City, Taiwan
- Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, Miao-Li County, Taiwan
| | - Ming-Shun Hsieh
- Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, Miao-Li County, Taiwan
- Department of Emergency Medicine, Taipei Veterans General Hospital, Tao-Yuan Branch, No. 100, Sec. 3, Cheng-Kung Road, Taoyuan, 330 Taiwan
- Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei City, Taiwan
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei City, Taiwan
| | - Yao-Tien Chang
- Institute of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd, Taichung City, 40201 Taiwan
- Department of Nursing, College of Health, National Taichung University of Technology and Science, Taichung City, Taiwan
| | - Chih-Che Huang
- Institute of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd, Taichung City, 40201 Taiwan
- Department of Medical Research, Taichung Veterans General Hospital, Taichung City, Taiwan
| | - Che-An Tsai
- Division of Infectious Disease, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung City, Taiwan
| | - Chung-Lin Tsai
- Division of Cardiovascular Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung City, Taiwan
| | - Chiann-Yi Hsu
- Department of Medical Research, Taichung Veterans General Hospital, Taichung City, Taiwan
| | - Chia-Hui Shen
- Department of Medical Research, Taichung Veterans General Hospital, Taichung City, Taiwan
| | - Yan-Zin Chang
- Institute of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd, Taichung City, 40201 Taiwan
- School of Medicine, Chung Shan Medical University, Taichung City, Taiwan
- Department of Clinical Laboratory, Drug Testing Center, Chung-Shan Medical University Hospital, Taichung, Taiwan
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5
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Standard “off-the-shelf” multibranched thoracoabdominal endograft in urgent and elective patients with single and staged procedures in a multicenter experience. J Vasc Surg 2018; 67:1005-1016. [DOI: 10.1016/j.jvs.2017.08.068] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 08/01/2017] [Indexed: 11/23/2022]
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6
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The American Association for the Surgery of Trauma uniform grading of hemorrhagic emergency general surgery diseases. J Trauma Acute Care Surg 2018; 84:670-673. [DOI: 10.1097/ta.0000000000001785] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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7
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Abstract
Non-invasive cross-sectional imaging techniques play a crucial role in the assessment of the varied manifestations of vascular disease. Vascular imaging encompasses a wide variety of pathology. Designing vascular imaging protocols can be challenging owing to the non-uniform velocity of blood in the aorta, differences in cardiac output between patients, and the effect of different disease states on blood flow. In this review, we provide the rationale behind—and a practical guide to—designing and implementing straightforward vascular computed tomography (CT) and magnetic resonance imaging (MRI) protocols. Teaching Points • There is a wide range of vascular pathologies requiring bespoke imaging protocols. • Variations in cardiac output and non-uniform blood velocity complicate vascular imaging. • Contrast media dose, injection rate and duration affect arterial enhancement in CTA. • Iterative CT reconstruction can improve image quality and reduce radiation dose. • MRA is of particular value when imaging small arteries and venous studies.
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8
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Talvitie M, Lindquist Liljeqvist M, Siika A, Hultgren R, Roy J. Localized Hyperattenuations in the Intraluminal Thrombus May Predict Rupture of Abdominal Aortic Aneurysms. J Vasc Interv Radiol 2018; 29:144-145. [DOI: 10.1016/j.jvir.2017.07.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 07/23/2017] [Accepted: 07/24/2017] [Indexed: 10/18/2022] Open
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9
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Georgakarakos E, Schoretsanitis N, Koufopoulos G, Paulou K, Lazarides MK. Abdominal Pain in the Presence of Small Abdominal Aortic Aneurysms: If in Doubt, Cut It Out! Ann Vasc Surg 2017; 40:300.e17-300.e21. [PMID: 28163182 DOI: 10.1016/j.avsg.2016.08.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 08/29/2016] [Accepted: 08/29/2016] [Indexed: 10/20/2022]
Abstract
Although small (<5 cm) abdominal aortic aneurysms (AAA) have been associated with symptoms and indication for intervention scarcely, the clinicians should never exclude such potential association especially in the absence of other overt pathological findings. In such cases, a surgical exploration with consequent intervention, if feasible, should be justified to prevent a detrimental evolution in a dubious scenario. In this article, we present 2 cases of patients with small AAA presenting with severe abdominal pain. In the absence of other solid clinical and radiological pathological findings, both patients underwent laparotomy where an inflammatory small AAA was identified and subjected either to resection and restoration with a tube graft or secondary endovascular repair because the periaortic fibrosis precluded the open repair. The characteristics and rationale of treatment modalities are exemplified and discussed.
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Affiliation(s)
- Efstratios Georgakarakos
- Medical School, Democritus University of Thrace, Alexandroupolis, Greece; Department of Vascular Surgery, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
| | - Nikolaos Schoretsanitis
- Department of Vascular Surgery, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | | | - Konstantinos Paulou
- Department of General Surgery, Sismanogleion General Hospital of Komotini, Komotini, Greece
| | - Miltos K Lazarides
- Medical School, Democritus University of Thrace, Alexandroupolis, Greece; Department of Vascular Surgery, University Hospital of Alexandroupolis, Alexandroupolis, Greece
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10
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Valente T, Rossi G, Lassandro F, Rea G, Marino M, Muto M, Molino A, Scaglione M. MDCT evaluation of acute aortic syndrome (AAS). Br J Radiol 2016; 89:20150825. [PMID: 27033344 DOI: 10.1259/bjr.20150825] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Non-traumatic acute thoracic aortic syndromes (AAS) describe a spectrum of life-threatening aortic pathologies with significant implications on diagnosis, therapy and management. There is a common pathway for the various manifestations of AAS that eventually leads to a breakdown of the aortic intima and media. Improvements in biology and health policy and diffusion of technology into the community resulted in an associated decrease in mortality and morbidity related to aortic therapeutic interventions. Hybrid procedures, branched and fenestrated endografts, and percutaneous aortic valves have emerged as potent and viable alternatives to traditional surgeries. In this context, current state-of-the art multidetector CT (MDCT) is actually the gold standard in the emergency setting because of its intrinsic diagnostic value. Management of acute aortic disease has changed with the increasing realization that endovascular therapies may offer distinct advantages in these situations. This article provides a summary of AAS, focusing especially on the MDCT technique, typical and atypical findings and common pitfalls of AAS, as well as recent concepts regarding the subtypes of AAS, consisting of aortic dissection, intramural haematoma, penetrating atherosclerotic ulcer and unstable aortic aneurysm or contained aortic rupture. MDCT findings will be related to pathophysiology, timing and management options to achieve a definite and timely diagnostic and therapeutic definition. In the present article, we review the aetiology, pathophysiology, clinical presentation, outcomes and therapeutic approaches to acute aortic syndromes.
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Affiliation(s)
- Tullio Valente
- 1 Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, Naples, Italy
| | - Giovanni Rossi
- 1 Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, Naples, Italy
| | - Francesco Lassandro
- 1 Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, Naples, Italy
| | - Gaetano Rea
- 1 Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, Naples, Italy
| | - Maurizio Marino
- 1 Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, Naples, Italy
| | - Maurizio Muto
- 1 Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, Naples, Italy
| | - Antonio Molino
- 2 Department of Pneumology, Section of Respiratory Diseases, University of Naples Federico II c/o Monaldi Hospital, Naples, Italy
| | - Mariano Scaglione
- 3 Department of Diagnostic Imaging, Presidio Ospedaliero "Pineta Grande", Caserta, Italy.,4 Department of Radiology, Darent Valley Hospital, Darfford, UK
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11
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Lahoz C, Gracia CE, García LR, Montoya SB, Hernando ÁB, Heredero ÁF, Tembra MS, Velasco MB, Guijarro C, Ruiz EB, Pintó X, de Ceniga MV, Moñux Ducajú G. [Not Available]. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2016; 28 Suppl 1:1-49. [PMID: 27107212 DOI: 10.1016/s0214-9168(16)30026-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Carlos Lahoz
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital Carlos III, Madrid, España.
| | - Carlos Esteban Gracia
- Servicio de Angiología y Cirugía Vascular, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | | | - Sergi Bellmunt Montoya
- Servicio de Angiología y Cirugía Vascular, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - Ángel Brea Hernando
- Unidad de Lípidos, Servicio de Medicina Interna, Hospital San Pedro, Logroño, España
| | | | - Manuel Suárez Tembra
- Unidad de Lípidos y Riesgo Cardiovascular, Servicio de Medicina Interna, Hospital San Rafael, A Coruña, España
| | - Marta Botas Velasco
- Servicio de Angiología y Cirugía Vascular, Hospital de Cabueñes, Gijón, España
| | - Carlos Guijarro
- Consulta de Riesgo Vascular, Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - Esther Bravo Ruiz
- Servicio de Angiología y Cirugía Vascular, Hospital Universitario de Basurto, Bilbao, España
| | - Xavier Pintó
- Unidad de Riesgo Vascular, Servicio de Medicina Interna, Hospital Universitario de Bellvitge, L' Hospitalet de Llobregat, Barcelona, España
| | - Melina Vega de Ceniga
- Servicio de Angiología y Cirugía Vascular, Hospital de Galdakao-Usansolo, Vizcaya, España
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12
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Sever A, Rheinboldt M. Unstable abdominal aortic aneurysms: a review of MDCT imaging features. Emerg Radiol 2016; 23:187-96. [PMID: 26797025 DOI: 10.1007/s10140-015-1374-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 12/29/2015] [Indexed: 11/27/2022]
Abstract
Abdominal aortic aneurysms are commonly encountered during abdominal CT imaging, and size-based parameters for surgical or endovascular repair are well established. Aneurysms greater than 5 cm in diameter are recognized as representing an increased rupture risk and meriting intervention. Increasingly, additional interest has been generated in recognizing imaging features which may herald instability and portend a higher chance for potentially catastrophic rupture. This article will review and illustrate such signs, including hyperattenuation of mural thrombus, rapid expansion, low thrombus to lumen ratio, intimal calcification disruption, posterior mural draping, and saccular outpouching. Other features of complicated abdominal aneurysms including perianeurysmal inflammation, aortocaval and aortoenteric fistula formation will also be addressed. Heightened awareness of these features and their prognostic implications, as well as timely communication with the clinical service, is critical for the interpreting radiologist.
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Affiliation(s)
- Alysse Sever
- Department of Radiology, Henry Ford Hospital, Detroit, MI, USA
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13
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Khan S, Verma V, Verma S, Polzer S, Jha S. Assessing the potential risk of rupture of abdominal aortic aneurysms. Clin Radiol 2014; 70:11-20. [PMID: 25544065 DOI: 10.1016/j.crad.2014.09.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 09/02/2014] [Accepted: 09/09/2014] [Indexed: 10/24/2022]
Abstract
Abdominal aortic aneurysms (AAAs) involve complex interplays between inflammatory and biomechanical factors that can be elucidated with anatomical and functional imaging. Although AAA size has been well-established in the literature to correlate with risk of rupture (and subsequent need for vascular intervention), there are other less-well-known characteristics about AAAs that also contribute to higher risk of rupture. This review focuses on biomechanical, radiological, and epidemiological characteristics of AAAs that are associated with higher rupture risk. For clinicians, knowing and considering a wide variety of risk factors in addition to AAA size is important to initiate early and proper intervention for AAA repair. Although there is no official quantitative risk score of AAA rupture risk that takes other non-size-related variables into account, if clinicians are aware of these other parameters, it is hoped that intervention can be appropriately performed for higher-risk AAAs that have not met the size-threshold for elective repair.
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Affiliation(s)
- S Khan
- Department of Medicine, University of Pittsburgh Medical Center - Mercy Hospital, Pittsburgh, PA, USA.
| | - V Verma
- Department of Medicine, University of Pittsburgh Medical Center - Mercy Hospital, Pittsburgh, PA, USA
| | - S Verma
- Department of Molecular Biology, Princeton University, Princeton, NJ, USA
| | - S Polzer
- Institute of Solid Mechanics, Mechatronics and Biomechanics, Brno University of Technology, Brno, Czech Republic
| | - S Jha
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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14
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Erbel R, Aboyans V, Boileau C, Bossone E, Bartolomeo RD, Eggebrecht H, Evangelista A, Falk V, Frank H, Gaemperli O, Grabenwöger M, Haverich A, Iung B, Manolis AJ, Meijboom F, Nienaber CA, Roffi M, Rousseau H, Sechtem U, Sirnes PA, Allmen RSV, Vrints CJM. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J 2014; 35:2873-926. [PMID: 25173340 DOI: 10.1093/eurheartj/ehu281] [Citation(s) in RCA: 2868] [Impact Index Per Article: 286.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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