Answer
Aortography has been the diagnostic criterion standard study for aortic dissection, but it is difficult to perform in patients with hemorrhage, shock, and/or cardiac tamponade. Aortography is being replaced by newer imaging modalities because of risks associated with invasiveness and adverse reactions to intravenous contrast agents.
Aortography (see the image below) leads to accurate diagnosis of aortic dissection in over 95% of patients and aids the surgeon in planning the repair operation because blood vessels of the arch can be assessed easily.
Angiogram demonstrating dissection of the aorta in a patient with aortic dissection presenting with hemothorax.
Benefits include visualization of the true and false lumens, intimal flap, aortic regurgitation, and coronary arteries.
Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!
Media Gallery
-
Aortic dissection. CT scan showing a flap (right side of image).
-
Aortic dissection. True lumen versus false lumen in an intimal flap.
-
Aortic dissection. Left subsegmental atelectasis and left pleural effusion. Flap at lower right of image.
-
Aortic dissection. Significant left pleural effusion.
-
Aortic dissection. CT scan showing a flap (center of image).
-
Aortic dissection. CT scan showing a flap (center of image).
-
Aortic dissection. CT scan showing a flap.
-
Aortic dissection. CT scan showing a flap.
-
Aortic dissection. Mediastinal widening.
-
Aortic dissection. CT scan showing a flap.
-
Aortic dissection. CT scan showing a flap.
-
Aortic dissection. CT scan showing a flap.
-
Aortic dissection. Thrombus and a patent lumen.
-
Aortic dissection. Thrombus.
-
Aortic dissection. True lumen and false lumen separated by an intimal flap.
-
Aortic dissection. Mediastinal widening.
-
Aortic dissection. CT scan showing a flap.
-
Aortic dissection. Intimal flap and left pleural effusion.
-
Image A represents a Stanford A or a DeBakey type 1 dissection. Image B represents a Stanford A or DeBakey type II dissection. Image C represents a Stanford type B or a DeBakey type III dissection. Image D is classified in a manner similar to A but contains an additional entry tear in the descending thoracic aorta. Note that a primary arch dissection does not fit neatly into either classification.
-
Aortic dissection.
-
Chest radiograph of a patient with aortic dissection. Image courtesy of Dr. K. London, University of California at Davis Medical Center.
-
Chest radiograph of a patient with aortic dissection presenting with hemothorax.
-
Chest radiograph demonstrating widened mediastinum in a patient with aortic dissection.
-
Angiogram demonstrating dissection of the aorta in a patient with aortic dissection presenting with hemothorax.
-
Electrocardiogram of a patient presenting to the ED with chest pain; this patient was diagnosed with aortic dissection.
-
Patient with an ascending type A aortic dissection showing the intimal flap. Image courtesy of Kaiser-Permanente.
-
Patient with an ascending type A aortic dissection showing the intimal flap. Image courtesy of Kaiser-Permanente.
-
Patient with an ascending type A aortic dissection showing the intimal flap. Image courtesy of Kaiser-Permanente.
-
Patient with an ascending type A aortic dissection showing the intimal flap. Image courtesy of Kaiser-Permanente.
-
Patient with a type A aortic dissection involving the ascending and descending aorta. Image courtesy of Kaiser-Permanente.
-
Patient with a type A aortic dissection involving the ascending and descending aorta. Image courtesy of Kaiser-Permanente.
-
Patient with a type A aortic dissection involving the ascending and descending aorta. Image courtesy of Kaiser-Permanente.
-
Patient with a type A aortic dissection involving the ascending and descending aorta. Image courtesy of Kaiser-Permanente.
-
Patient showing a type B aortic dissection with extravasation of blood into the pleural cavity. Image courtesy of Kaiser-Permanente.
-
Patient showing a type B aortic dissection with extravasation of blood into the pleural cavity. Image courtesy of Kaiser-Permanente.
-
Patient showing a type B aortic dissection with extravasation of blood into the pleural cavity. Image courtesy of Kaiser-Permanente.
-
Patient showing a type B aortic dissection with extravasation of blood into the pleural cavity. Image courtesy of Kaiser-Permanente.
of
37
