Thoracic aortic dissection classification among radiologists and surgeons and management trends

Jaselyn Grant, Ariel Z. Allen, Leah Traube, Jeffrey M. Levsky, Linda B. Haramati

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: To investigate the discrepancy rate in classification of newly diagnosed aortic dissection (AD) between radiologists and surgeons and explore patient management. Methods: 3255 CTs performed for AD from June 2013 to June 2018 at our institution were retrospectively identified. CT reports and charts were reviewed to identify newly diagnosed AD or intramural hematoma (IMH). Radiology reports and electronic health records were reviewed for Stanford type A or B classification and surgical versus medical management. Results: Newly diagnosed AD was diagnosed in 1.9% (62/3255) with one false positive, mean age 60 years. Discrepancy rate was 1.6% (1/61). Type A AD/IMH was treated surgically in 85% (23/27), medically in 15% (4/27). Type B AD/IMH was treated surgically in 56% (19/34) (endovascular 95% (18/19)), medically in 44% (15/34). Conclusions: Discrepancy rate between radiologists and surgeons in Stanford classification of aortic dissection was low. Management of type B AD/IMH was predominantly endovascular, reflecting a shift in practice from the historical binary management strategy of type A dissections being treated surgically and type B dissections medically.

Original languageEnglish (US)
Pages (from-to)297-301
Number of pages5
JournalEmergency Radiology
Volume28
Issue number2
DOIs
StatePublished - Apr 2021

Keywords

  • Aortic dissection
  • Intramural hematoma
  • Stanford classification
  • Type B dissection management

ASJC Scopus subject areas

  • Emergency Medicine
  • Radiology Nuclear Medicine and imaging

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