Entry tear hemodynamics using 4D flow MRI in a patient with acute type B aortic dissection

Liu, Sophia Z.; Engel, Joshua S.; Bisen, Jay B.; Kilinç, Özden; Quinn, Sandra Crouse; Hoel, Andrew W.; Mehta, Christopher K.; Markl, Michael; Allen, Bradley D.

doi:10.1016/j.radcr.2022.12.033

Cited by 3 publications

(1 citation statement)

References 7 publications

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“…Indeed, thoracic endovascular aortic repair (TEVAR) requires lifelong postoperative surveillance, as it could be affected by long-term complications, such as endoleaks [ 9 ], which are defined as a persistent blood flow outside the stent and within the vessel walls, stent collapse, stent infection, and stent migration. A flow analysis utilizing 4D Flow MRI has been applied as a diagnostic tool in type B aortic dissection in which analyzing the flow through the primary entry tear from the native true lumen into the false lumen may help to predict adverse outcomes and aid in risk-stratifying patients for pre-emptive surgical/endovascular procedures [ 10 , 11 ]. The mechanical coupling between thoracic aortic stent grafts and the aorta represents a main issue in the follow-up of patients treated with TEVAR, and requires more exploration and optimization to improve the clinical outcomes, especially in the case of the patients submitted to an endovascular procedure for acute type B aortic dissection.…”

Section: Introductionmentioning

confidence: 99%

Four-Dimensional Flow MRI for the Evaluation of Aortic Endovascular Graft: A Pilot Study

Righini,

Secchi,

Mazzaccaro

et al. 2023

Diagnostics

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We aimed to explore the feasibility of 4D flow magnetic resonance imaging (MRI) for patients undergoing thoracic aorta endovascular repair (TEVAR). We retrospectively evaluated ten patients (two female), with a mean (±standard deviation) age of 61 ± 20 years, undergoing MRI for a follow-up after TEVAR. All 4D flow examinations were performed using a 1.5-T system (MAGNETOM Aera, Siemens Healthcare, Erlangen, Germany). In addition to the standard examination protocol, a 4D flow-sensitive 3D spatial-encoding, time-resolved, phase-contrast prototype sequence was acquired. Among our cases, flow evaluation was feasible in all patients, although we observed some artifacts in 3 out of 10 patients. Three individuals displayed a reduced signal within the vessel lumen where the endograft was placed, while others presented with turbulent or increased flow. An aortic endograft did not necessarily hinder the visualization of blood flow through 4D flow sequences, although the graft could generate flow artifacts in some cases. A 4D Flow MRI may represent the ideal tool to follow up on both healthy subjects deemed to be at an increased risk based on their anatomical characteristics or patients submitted to TEVAR for whom a surveillance protocol with computed tomography angiography would be cumbersome and unjustified.

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Section: Introductionmentioning

confidence: 99%