The potential role of quantitative digital subtraction angiography in evaluating type B chronic aortic dissection during TEVAR: preliminary results

G Tinelli, F Minelli, F De Nigris, C Vincenzoni, M Filipponi, P Bruno, M Massetti, A Flex, R Iezzi

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: To evaluate the role of quantitative digital subtraction angiography (Q-DSA) with parametric color coding (PCC) in assessing patients with type B chronic thoracic aortic dissection (TBCAD) during thoracic endovascular aortic repair (TEVAR) procedures.

PATIENTS AND METHODS: A total of 11 patients electively treated in our Department for a TBCAD were retrospectively enrolled. All cases were treated with TEVAR for false lumen aneurysm of the thoracic descending aorta. For digital subtraction angiography (DSA) series post-processing, a newly implemented PCC algorithm was used to turn consecutive two-dimensional images into a single color-coded picture (syngo iFLOW, Siemens AG, Forchheim, Germany). In consensus reading, two clinicians experienced in vascular imaging evaluated the DSA series in blinded assessment and compared them to the color-coded images. PCC was assessed for its accuracy in identifying the true and false lumen as well as whether it could provide improved visualization in pre-deployment stent grafting and the final evaluation of treatment.

RESULTS: PCC facilitated the visualization of the aortic dissection angioarchitecture in terms of contemporary true and false lumen vision in 81.8% of the cases. In 72.7% of the procedures, Q-DSA was estimated to improve aorta information assessment in terms of false lumen viewing, and it was possible to identify the proximal entry tear position in 45.4% of the cases. After stent graft deployment, in 72.7% of the cases (all 8 patients in which the aortic arch false lumen was visible in pre-treatment), Q-DSA confirmed the absence of early false lumen reperfusion.

CONCLUSIONS: Our results indicate that Q-DSA could be useful in the intraprocedural evaluation of patients with aortic dissection during TEVAR procedures without additional x-ray costs and contrast exposure.

Original languageEnglish
Pages (from-to)516-522
Number of pages7
JournalEuropean Review for Medical and Pharmacological Sciences
Volume22
Issue number2
DOIs
Publication statusPublished - Jan 2018

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