A new classification system for branch artery perfusion patterns in acute aortic dissection for examining the effects of central aortic repair
OBJECTIVES We developed a new classification system for branch perfusion patterns in acute aortic dissection and used it to retrospectively evaluate the perfusion status of whole aortic branches and to examine the effects of central aortic repair. METHODS Thirty-four consecutive patients with acute...
Gespeichert in:
| Veröffentlicht in: | European journal of cardio-thoracic surgery 2013-07, Vol.44 (1), p.146-153 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 153 |
|---|---|
| container_issue | 1 |
| container_start_page | 146 |
| container_title | European journal of cardio-thoracic surgery |
| container_volume | 44 |
| creator | Nagamine, Hiroshi Ueno, Yosuke Ueda, Hideyasu Saito, Daisuke Tanaka, Nobuhiro Miyazaki, Manami Hara, Hiroiku Kawase, Yushi |
| description | OBJECTIVES
We developed a new classification system for branch perfusion patterns in acute aortic dissection and used it to retrospectively evaluate the perfusion status of whole aortic branches and to examine the effects of central aortic repair.
METHODS
Thirty-four consecutive patients with acute type A aortic dissection underwent emergent surgery at our institution between August 2008 and December 2011. A retrospective review of pre- and postoperative computed tomographic angiography was performed. Branch perfusion patterns were categorized into three classes: Class I, dissection involving but not extending into the branch; Class II, dissection extending into the branch and Class III, dissection causing ostial avulsion.
RESULTS
In cervical branches (total 169 branches), 70 branches (41%) presented with Class I patterns, 58 (34%) with Class II and none with Class III. In abdominal branches (total 135 branches), 76 branches (56%) presented with Class I patterns, 12 (9%) with Class II and 18 (13%) with Class III. In common iliac arteries (total 68 arteries), 14 arteries (21%) presented with Class I patterns, 24 (35%) with Class II and none with Class III. After repair, among 21 high-risk cervical branches, 14 branches (67%) showed improvement, 3 (14%) preserved distal perfusion supplied through the patent branch false lumen and 4 (19%) showed no improvement in high-risk perfusion pattern or worsened. Among 22 high-risk abdominal branches, 18 branches (82%) showed improvement, 3 (14%) preserved distal perfusion supplied through the patent branch or aortic false lumen and 1 (5%) showed no improvement in high-risk perfusion pattern.
CONCLUSIONS
To overcome malperfusion syndromes associated with acute aortic dissection, recognition of diverse branch perfusion patterns through a universal classification system is imperative. |
| doi_str_mv | 10.1093/ejcts/ezs631 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1367883320</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ejcts/ezs631</oup_id><sourcerecordid>1367883320</sourcerecordid><originalsourceid>FETCH-LOGICAL-c427t-3b289ac093fe83cc3401eb32c70d664118010699964351674459c6ee7c0d6bdc3</originalsourceid><addsrcrecordid>eNp9kUFP3DAQha2KqlDaW8-Vb3Boih177eSIUGmRkLiA1FvkzI6LUeIEjyO6_Ij-ZrwscOxpRjPfPOnNY-yLFN-laNUJ3kGmE3wko-Q7diAbqyqr9O-90gspKttqsc8-Et0JIYyq7Qe2X6ta122zOmD_TnnEBw6DIwo-gMthipw2lHHkfkq8Ty7CLXcpY9rwGZNfaIvMLpdJJB4id7Bk5G5KOQBfByKEZ5ntPf51Y4gh_uH5Fjl6X3bEJ88BY05ueD1LOLuQPrH33g2En1_qIbs5_3F99qu6vPp5cXZ6WYGuba5UXzetg2LfY6MAlBYSe1WDFWtjtJRNcW7atjVaraSxWq9aMIgWyr5fgzpkxzvdOU33C1LuxkCAw-AiTgt1UhnbNErVoqDfdiikiSih7-YURpc2nRTdNoHuOYFul0DBv74oL_2I6zf49eUFONoB0zL_X-oJ3L6TgQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1367883320</pqid></control><display><type>article</type><title>A new classification system for branch artery perfusion patterns in acute aortic dissection for examining the effects of central aortic repair</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Nagamine, Hiroshi ; Ueno, Yosuke ; Ueda, Hideyasu ; Saito, Daisuke ; Tanaka, Nobuhiro ; Miyazaki, Manami ; Hara, Hiroiku ; Kawase, Yushi</creator><creatorcontrib>Nagamine, Hiroshi ; Ueno, Yosuke ; Ueda, Hideyasu ; Saito, Daisuke ; Tanaka, Nobuhiro ; Miyazaki, Manami ; Hara, Hiroiku ; Kawase, Yushi</creatorcontrib><description>OBJECTIVES
We developed a new classification system for branch perfusion patterns in acute aortic dissection and used it to retrospectively evaluate the perfusion status of whole aortic branches and to examine the effects of central aortic repair.
METHODS
Thirty-four consecutive patients with acute type A aortic dissection underwent emergent surgery at our institution between August 2008 and December 2011. A retrospective review of pre- and postoperative computed tomographic angiography was performed. Branch perfusion patterns were categorized into three classes: Class I, dissection involving but not extending into the branch; Class II, dissection extending into the branch and Class III, dissection causing ostial avulsion.
RESULTS
In cervical branches (total 169 branches), 70 branches (41%) presented with Class I patterns, 58 (34%) with Class II and none with Class III. In abdominal branches (total 135 branches), 76 branches (56%) presented with Class I patterns, 12 (9%) with Class II and 18 (13%) with Class III. In common iliac arteries (total 68 arteries), 14 arteries (21%) presented with Class I patterns, 24 (35%) with Class II and none with Class III. After repair, among 21 high-risk cervical branches, 14 branches (67%) showed improvement, 3 (14%) preserved distal perfusion supplied through the patent branch false lumen and 4 (19%) showed no improvement in high-risk perfusion pattern or worsened. Among 22 high-risk abdominal branches, 18 branches (82%) showed improvement, 3 (14%) preserved distal perfusion supplied through the patent branch or aortic false lumen and 1 (5%) showed no improvement in high-risk perfusion pattern.
CONCLUSIONS
To overcome malperfusion syndromes associated with acute aortic dissection, recognition of diverse branch perfusion patterns through a universal classification system is imperative.</description><identifier>ISSN: 1010-7940</identifier><identifier>EISSN: 1873-734X</identifier><identifier>DOI: 10.1093/ejcts/ezs631</identifier><identifier>PMID: 23242985</identifier><language>eng</language><publisher>Germany: Oxford University Press</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Aneurysm, Dissecting - classification ; Aneurysm, Dissecting - physiopathology ; Aneurysm, Dissecting - surgery ; Angiography - methods ; Aorta - physiopathology ; Aorta - surgery ; Aortic Aneurysm - classification ; Aortic Aneurysm - physiopathology ; Aortic Aneurysm - surgery ; Female ; Humans ; Iliac Artery - physiopathology ; Male ; Middle Aged ; Models, Cardiovascular ; Regional Blood Flow - physiology ; Reperfusion ; Retrospective Studies ; Severity of Illness Index ; Tomography, X-Ray Computed - methods ; Vascular Surgical Procedures</subject><ispartof>European journal of cardio-thoracic surgery, 2013-07, Vol.44 (1), p.146-153</ispartof><rights>The Author 2012, 2013. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c427t-3b289ac093fe83cc3401eb32c70d664118010699964351674459c6ee7c0d6bdc3</citedby><cites>FETCH-LOGICAL-c427t-3b289ac093fe83cc3401eb32c70d664118010699964351674459c6ee7c0d6bdc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1584,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23242985$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nagamine, Hiroshi</creatorcontrib><creatorcontrib>Ueno, Yosuke</creatorcontrib><creatorcontrib>Ueda, Hideyasu</creatorcontrib><creatorcontrib>Saito, Daisuke</creatorcontrib><creatorcontrib>Tanaka, Nobuhiro</creatorcontrib><creatorcontrib>Miyazaki, Manami</creatorcontrib><creatorcontrib>Hara, Hiroiku</creatorcontrib><creatorcontrib>Kawase, Yushi</creatorcontrib><title>A new classification system for branch artery perfusion patterns in acute aortic dissection for examining the effects of central aortic repair</title><title>European journal of cardio-thoracic surgery</title><addtitle>Eur J Cardiothorac Surg</addtitle><description>OBJECTIVES
We developed a new classification system for branch perfusion patterns in acute aortic dissection and used it to retrospectively evaluate the perfusion status of whole aortic branches and to examine the effects of central aortic repair.
METHODS
Thirty-four consecutive patients with acute type A aortic dissection underwent emergent surgery at our institution between August 2008 and December 2011. A retrospective review of pre- and postoperative computed tomographic angiography was performed. Branch perfusion patterns were categorized into three classes: Class I, dissection involving but not extending into the branch; Class II, dissection extending into the branch and Class III, dissection causing ostial avulsion.
RESULTS
In cervical branches (total 169 branches), 70 branches (41%) presented with Class I patterns, 58 (34%) with Class II and none with Class III. In abdominal branches (total 135 branches), 76 branches (56%) presented with Class I patterns, 12 (9%) with Class II and 18 (13%) with Class III. In common iliac arteries (total 68 arteries), 14 arteries (21%) presented with Class I patterns, 24 (35%) with Class II and none with Class III. After repair, among 21 high-risk cervical branches, 14 branches (67%) showed improvement, 3 (14%) preserved distal perfusion supplied through the patent branch false lumen and 4 (19%) showed no improvement in high-risk perfusion pattern or worsened. Among 22 high-risk abdominal branches, 18 branches (82%) showed improvement, 3 (14%) preserved distal perfusion supplied through the patent branch or aortic false lumen and 1 (5%) showed no improvement in high-risk perfusion pattern.
CONCLUSIONS
To overcome malperfusion syndromes associated with acute aortic dissection, recognition of diverse branch perfusion patterns through a universal classification system is imperative.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aneurysm, Dissecting - classification</subject><subject>Aneurysm, Dissecting - physiopathology</subject><subject>Aneurysm, Dissecting - surgery</subject><subject>Angiography - methods</subject><subject>Aorta - physiopathology</subject><subject>Aorta - surgery</subject><subject>Aortic Aneurysm - classification</subject><subject>Aortic Aneurysm - physiopathology</subject><subject>Aortic Aneurysm - surgery</subject><subject>Female</subject><subject>Humans</subject><subject>Iliac Artery - physiopathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Models, Cardiovascular</subject><subject>Regional Blood Flow - physiology</subject><subject>Reperfusion</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Vascular Surgical Procedures</subject><issn>1010-7940</issn><issn>1873-734X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUFP3DAQha2KqlDaW8-Vb3Boih177eSIUGmRkLiA1FvkzI6LUeIEjyO6_Ij-ZrwscOxpRjPfPOnNY-yLFN-laNUJ3kGmE3wko-Q7diAbqyqr9O-90gspKttqsc8-Et0JIYyq7Qe2X6ta122zOmD_TnnEBw6DIwo-gMthipw2lHHkfkq8Ty7CLXcpY9rwGZNfaIvMLpdJJB4id7Bk5G5KOQBfByKEZ5ntPf51Y4gh_uH5Fjl6X3bEJ88BY05ueD1LOLuQPrH33g2En1_qIbs5_3F99qu6vPp5cXZ6WYGuba5UXzetg2LfY6MAlBYSe1WDFWtjtJRNcW7atjVaraSxWq9aMIgWyr5fgzpkxzvdOU33C1LuxkCAw-AiTgt1UhnbNErVoqDfdiikiSih7-YURpc2nRTdNoHuOYFul0DBv74oL_2I6zf49eUFONoB0zL_X-oJ3L6TgQ</recordid><startdate>20130701</startdate><enddate>20130701</enddate><creator>Nagamine, Hiroshi</creator><creator>Ueno, Yosuke</creator><creator>Ueda, Hideyasu</creator><creator>Saito, Daisuke</creator><creator>Tanaka, Nobuhiro</creator><creator>Miyazaki, Manami</creator><creator>Hara, Hiroiku</creator><creator>Kawase, Yushi</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130701</creationdate><title>A new classification system for branch artery perfusion patterns in acute aortic dissection for examining the effects of central aortic repair</title><author>Nagamine, Hiroshi ; Ueno, Yosuke ; Ueda, Hideyasu ; Saito, Daisuke ; Tanaka, Nobuhiro ; Miyazaki, Manami ; Hara, Hiroiku ; Kawase, Yushi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c427t-3b289ac093fe83cc3401eb32c70d664118010699964351674459c6ee7c0d6bdc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aneurysm, Dissecting - classification</topic><topic>Aneurysm, Dissecting - physiopathology</topic><topic>Aneurysm, Dissecting - surgery</topic><topic>Angiography - methods</topic><topic>Aorta - physiopathology</topic><topic>Aorta - surgery</topic><topic>Aortic Aneurysm - classification</topic><topic>Aortic Aneurysm - physiopathology</topic><topic>Aortic Aneurysm - surgery</topic><topic>Female</topic><topic>Humans</topic><topic>Iliac Artery - physiopathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Models, Cardiovascular</topic><topic>Regional Blood Flow - physiology</topic><topic>Reperfusion</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Vascular Surgical Procedures</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nagamine, Hiroshi</creatorcontrib><creatorcontrib>Ueno, Yosuke</creatorcontrib><creatorcontrib>Ueda, Hideyasu</creatorcontrib><creatorcontrib>Saito, Daisuke</creatorcontrib><creatorcontrib>Tanaka, Nobuhiro</creatorcontrib><creatorcontrib>Miyazaki, Manami</creatorcontrib><creatorcontrib>Hara, Hiroiku</creatorcontrib><creatorcontrib>Kawase, Yushi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cardio-thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nagamine, Hiroshi</au><au>Ueno, Yosuke</au><au>Ueda, Hideyasu</au><au>Saito, Daisuke</au><au>Tanaka, Nobuhiro</au><au>Miyazaki, Manami</au><au>Hara, Hiroiku</au><au>Kawase, Yushi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A new classification system for branch artery perfusion patterns in acute aortic dissection for examining the effects of central aortic repair</atitle><jtitle>European journal of cardio-thoracic surgery</jtitle><addtitle>Eur J Cardiothorac Surg</addtitle><date>2013-07-01</date><risdate>2013</risdate><volume>44</volume><issue>1</issue><spage>146</spage><epage>153</epage><pages>146-153</pages><issn>1010-7940</issn><eissn>1873-734X</eissn><abstract>OBJECTIVES
We developed a new classification system for branch perfusion patterns in acute aortic dissection and used it to retrospectively evaluate the perfusion status of whole aortic branches and to examine the effects of central aortic repair.
METHODS
Thirty-four consecutive patients with acute type A aortic dissection underwent emergent surgery at our institution between August 2008 and December 2011. A retrospective review of pre- and postoperative computed tomographic angiography was performed. Branch perfusion patterns were categorized into three classes: Class I, dissection involving but not extending into the branch; Class II, dissection extending into the branch and Class III, dissection causing ostial avulsion.
RESULTS
In cervical branches (total 169 branches), 70 branches (41%) presented with Class I patterns, 58 (34%) with Class II and none with Class III. In abdominal branches (total 135 branches), 76 branches (56%) presented with Class I patterns, 12 (9%) with Class II and 18 (13%) with Class III. In common iliac arteries (total 68 arteries), 14 arteries (21%) presented with Class I patterns, 24 (35%) with Class II and none with Class III. After repair, among 21 high-risk cervical branches, 14 branches (67%) showed improvement, 3 (14%) preserved distal perfusion supplied through the patent branch false lumen and 4 (19%) showed no improvement in high-risk perfusion pattern or worsened. Among 22 high-risk abdominal branches, 18 branches (82%) showed improvement, 3 (14%) preserved distal perfusion supplied through the patent branch or aortic false lumen and 1 (5%) showed no improvement in high-risk perfusion pattern.
CONCLUSIONS
To overcome malperfusion syndromes associated with acute aortic dissection, recognition of diverse branch perfusion patterns through a universal classification system is imperative.</abstract><cop>Germany</cop><pub>Oxford University Press</pub><pmid>23242985</pmid><doi>10.1093/ejcts/ezs631</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1010-7940 |
| ispartof | European journal of cardio-thoracic surgery, 2013-07, Vol.44 (1), p.146-153 |
| issn | 1010-7940 1873-734X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1367883320 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Adult Aged Aged, 80 and over Aneurysm, Dissecting - classification Aneurysm, Dissecting - physiopathology Aneurysm, Dissecting - surgery Angiography - methods Aorta - physiopathology Aorta - surgery Aortic Aneurysm - classification Aortic Aneurysm - physiopathology Aortic Aneurysm - surgery Female Humans Iliac Artery - physiopathology Male Middle Aged Models, Cardiovascular Regional Blood Flow - physiology Reperfusion Retrospective Studies Severity of Illness Index Tomography, X-Ray Computed - methods Vascular Surgical Procedures |
| title | A new classification system for branch artery perfusion patterns in acute aortic dissection for examining the effects of central aortic repair |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-19T01%3A25%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20new%20classification%20system%20for%20branch%20artery%20perfusion%20patterns%20in%20acute%20aortic%20dissection%20for%20examining%20the%20effects%20of%20central%20aortic%20repair&rft.jtitle=European%20journal%20of%20cardio-thoracic%20surgery&rft.au=Nagamine,%20Hiroshi&rft.date=2013-07-01&rft.volume=44&rft.issue=1&rft.spage=146&rft.epage=153&rft.pages=146-153&rft.issn=1010-7940&rft.eissn=1873-734X&rft_id=info:doi/10.1093/ejcts/ezs631&rft_dat=%3Cproquest_cross%3E1367883320%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1367883320&rft_id=info:pmid/23242985&rft_oup_id=10.1093/ejcts/ezs631&rfr_iscdi=true |