What is the role of aortography in the workup of thoracic aortic aneurysm (TAA)?

Updated: Apr 02, 2021
  • Author: Elaine Tseng, MD; Chief Editor: Mary C Mancini, MD, PhD, MMM  more...
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Aortography (see the image below) can delineate the aortic lumen, and it can help define the extent of the aneurysm, any branch vessel involvement, and the stenosis of branch vessels. It describes the takeoff of the coronary ostia.

Ascending aortogram showing ascending aortic aneur Ascending aortogram showing ascending aortic aneurysm. Patient also underwent computed tomography (CT).

For patients older than 40 years or those with a history suggestive of coronary artery disease, aortography helps evaluate coronary anatomy, ventricular function by ventriculography, and aortic insufficiency. It does not help in defining the size of the aneurysm, because the outer diameter is not measured, which may miss dissections.

Disadvantages include the use of nephrotoxic contrast and radiation. The risk of aortography includes embolization from laminated thrombus and carries a 1% stroke risk.

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