Value of triple rule-out CT in the emergency department

Soliman, Hazem Hamed

doi:10.1016/j.ejrnm.2015.03.010

Cited by 7 publications

(10 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent TRO CTA study was done using 320-multislice CT on 25 low to intermediate acute chest pain patients. Using TRO CTA, they were able to diagnose 50% of their patients of having coronary lesions [25]. Our result is perfectly matching with their result as we found 57.8% of our patients having coronary artery disease, but we included only intermediate risk patients in our study and larger study population.…”

Section: Tro Cta Behaviour In the Assessment Of Coronary Diseasesupporting

confidence: 87%

“…We found that our estimated effective dose value (EDV = 9.7 mSv) was slightly lower than of Soliman [25] and Gruettner et al [38] TRO studies who had EDV reaching to 10 and 12.4 mSv respectively. Our EDV was still higher than EDV of patients underwent dedicated coronary CTA in the Joachim Gruettner study as they got 8.7 mSv.…”

Section: Tro Cta and Radiation Exposurecontrasting

confidence: 74%

“…In our study, we were able to diagnose pulmonary embolism, aortic intramural hematoma and aortic dissection as emergency causes of acute chest pain. In Soliman TRO CTA study [25] done on acute chest pain patients, he diagnosed 17 cases with non-coronary findings including pulmonary embolism (12.5%), aortic dissection (22.5%) and aortic aneurysm (10%).…”

Section: Tro Cta Behaviour In Assessment Of Non-coronary Diseasementioning

confidence: 99%

See 2 more Smart Citations

‘Triple-rule-out’ CT angiography for clinical decision making and early triage of acute chest pain patients: use of 320-multislice CT angiography

Eltabbakh

Dawoud

Langer

et al. 2019

Egypt J Radiol Nucl Med

View full text Add to dashboard Cite

Background: In our study, we aimed to estimate utility of TRO CTA to guide clinical decision in acute chest pain patients with intermediate risk to acute coronary syndrome (ACS) in the emergency department.Methods and material: Our study population included 45 acute chest pain patients with intermediate-risk ACS. All these patients had done TRO CTA to access any pathological conditions in the coronary artery, pulmonary artery, aorta and thoracic diseases that may be the cause of their complaint. Follow-up was done in all patients for 60 days.Results: Among the 45 patients, we were able to discharge 44.4% (20 out of 45) of our population safely to home with no need for further diagnostic cardiac testing. The rest of the patients were classified into significant coronary artery disease 40% (18 out of 45), 8.8% (4 out of 45) had acute aortic lesions and 6.6% (3 out 45) had pulmonary artery embolization.Conclusions: Triple Role Out CT angiography (TRO CTA) is not only an effective protocol for exclusion of ACS with high specificity compared to dedicated coronary CTA but also in the diagnosis of acute chest pain due to other vascular and non-vascular causes helping decision-making strategy for admission in the emergency department.

show abstract

Section: Tro Cta Behaviour In the Assessment Of Coronary Diseasesupporting

confidence: 87%

Section: Tro Cta and Radiation Exposurecontrasting

confidence: 74%

Section: Tro Cta Behaviour In Assessment Of Non-coronary Diseasementioning

confidence: 99%

See 1 more Smart Citation

‘Triple-rule-out’ CT angiography for clinical decision making and early triage of acute chest pain patients: use of 320-multislice CT angiography

Eltabbakh

Dawoud

Langer

et al. 2019

Egypt J Radiol Nucl Med

View full text Add to dashboard Cite

show abstract

“…Those were the targeted people by our study (TRO) which is tailored to widen the benefit of the CT scan to identify other causes of acute chest pain when IHD is excluded by CCTA. Some studies have demonstrated the application of a triple rule-out protocol with16 and 320 multi-detector CT technology in the ED [3,[21][22][23][24][25]. In this study the researchers utilized was a 128-MDCT (somatom Di Fintion Flash Siemens Health Care Forchheim, Germany), and 64-MDCT (Brilliance Pro, Philips Healthcare), both machines are available in the study setting.…”

Section: Discussionmentioning

confidence: 99%

“…This study differs from other studies as we did not perform coronary angiography except in cases with significant stenosis. We considered that good quality CCTA is having a reliable negative predictive value (99.4%) [24] and we can exclude the presence of significant coronary artery obstruction with high degree of confidence. This agrees with many studies which demonstrated that a normal CCTA allows the clinician to rule out the presence of significant coronary artery stenosis with a high degree of reliability, and that no further work-up is required to demonstrate the absence of coronary disease [2,18,26,29].…”

Section: Discussionmentioning

confidence: 99%

“Triple-Rule-Out” in Investigating Cases of Acute Chest Pain (Saudi Experience)

Saad¹

2018

JOCCT

View full text Add to dashboard Cite

Objective: Triple Rule-Out (TRO) is a recent Technique for evaluating Emergency Department (ED) acute Chest Pain Patients. The aim of this study is to assess the effectiveness of TRO in identifying the cause of acute chest in emergency department. Materials and Methods:This is a prospective study done in Kingdom of Saudi Arabia (KSA) tertiary referral hospital during the period between March 2014 and June 2017. 237 patients who fulfill the inclusion criteria and continue all follow up visits for six months were included. They were presented to ED with acute chest pain suspected to be acute coronary syndrome. Their ages ranged between 29 and 72 years old with the mean age of 42.8 years. 164 patients were males and the rest were females. TRO was performed to all of them using a 64 and 128 Multi-Detector Computed Tomography (MDCT) scanners. Results:According to the results of TRO, the patients had fallen into one of the three groups: (1) Patients with coronary artery disease including 62 patients (26.2%) and were classified according to the severity of the coronary artery stenosis into mild, moderate, and severe stenosis subgroups.(2) Patients with extra-coronary diseases that explain patient's complaints including 94 patients (39.7%). (3) Patients without obvious disease which can explain patient's complaints including 81 patients (34.1%). Additional 136 extra-coronary incidental findings which are not related to the presenting complaints were reported and were treated accordingly.Conclusions: TRO examination is a fast and useful technique in mak¬ing a quick and accurate diagnosis in patients presented to ED with acute non-traumatic chest pain. It allows imaging of the coronary arteries, entire chest, and upper abdominal organs with rapid acquisition and data reconstruction to provide prompt and accurate diagnosis. It is also used to identify many of clinically significant non-cardiac findings that may have an impact on the management of those patients.

show abstract

“Triple Rule Out” CT scan in Emergency Department Patients

2023

The Egyptian Journal of Hospital Medicine

View full text Add to dashboard Cite

Background: Although conventional coronary angiography is the gold standard tool of diagnosing coronary artery disease (CAD), it is an invasive procedure, and it can miss non-coronary causes of acute chest pain. Triple role out CT has emerged as a promising tool for assessment of such cases. Herein, we present our experience in comparing "triple out CT" as a diagnostic tool for acute chest pain patients. Objective: The aim of the current study was to assess the validity and efficacy of triple rule-out CT in diagnosis of different vascular causes of chest pain in the Emergency Department. Patients and methods: The data of 50 patients with an intermediate risk for CAD were retrospectively reviewed. All of them underwent the triple out protocol, and when coronary cause was established, conventional angiography was done. Results: CT angiography (CTA) revealed CAD in 29 (58%) subjects, while non-coronary disease was detected in 12 (24%) patients. The remaining nine subjects had negative CTA study. In the patients diagnosed with CAD, most of them had severe disease (82.8%), whereas the remaining five patients had moderate one. Findings rather than CAD included pulmonary embolism, mediastinal mass, acute aortic disease, pulmonary disease, hernia, and pulmonary artery aneurysm. There was a significant relation agreement between CTA and cardiac catheterization regarding the severity of CAD (P<0.001). Conclusion: Triple out CT could be a surrogate diagnostic modality for patients with acute chest pain, even when CAD is suspected. It can yield comparable results compared to the conventional coronary angiography. Therefore, its application is widely recommended in low-source emergency settings.

show abstract

Value of triple rule-out CT in the emergency department

Cited by 7 publications

References 17 publications

‘Triple-rule-out’ CT angiography for clinical decision making and early triage of acute chest pain patients: use of 320-multislice CT angiography

‘Triple-rule-out’ CT angiography for clinical decision making and early triage of acute chest pain patients: use of 320-multislice CT angiography

“Triple-Rule-Out” in Investigating Cases of Acute Chest Pain (Saudi Experience)

“Triple Rule Out” CT scan in Emergency Department Patients

Contact Info

Product

Resources

About