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False lumen hemodynamics and partial thrombosis in chronic aortic dissection of the descending aorta.
Ruiz-Muñoz, Aroa; Guala, Andrea; Dux-Santoy, Lydia; Teixidó-Turà, Gisela; Valente, Filipa; Garrido-Oliver, Juan; Galian-Gay, Laura; Gutiérrez, Laura; Fernandez-Galera, Rubén; Casas-Masnou, Guillem; González-Alujas, Teresa; Cuéllar-Calabria, Hug; Carrasco-Poves, Alejandro; Morales-Galán, Alberto; Johnson, Kevin M; Wieben, Oliver; Ferreira-González, Ignacio; Evangelista, Arturo; Rodriguez-Palomares, Jose.
Afiliación
  • Ruiz-Muñoz A; Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.
  • Guala A; CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.
  • Dux-Santoy L; Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain.
  • Teixidó-Turà G; Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.
  • Valente F; Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain. andrea.guala@vhir.org.
  • Garrido-Oliver J; CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain. andrea.guala@vhir.org.
  • Galian-Gay L; Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain. andrea.guala@vhir.org.
  • Gutiérrez L; Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.
  • Fernandez-Galera R; Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.
  • Casas-Masnou G; CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.
  • González-Alujas T; Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain.
  • Cuéllar-Calabria H; Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain.
  • Carrasco-Poves A; Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.
  • Morales-Galán A; Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain.
  • Johnson KM; Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain.
  • Wieben O; Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain.
  • Ferreira-González I; Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain.
  • Evangelista A; Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain.
  • Rodriguez-Palomares J; Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.
Eur Radiol ; 34(8): 5190-5200, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38183450
ABSTRACT

OBJECTIVES:

Partial thrombosis of the false lumen (FL) in patients with chronic aortic dissection (AD) of the descending aorta has been associated with poor outcomes. Meanwhile, the fluid dynamic and biomechanical characteristics associated with partial thrombosis remain to be elucidated. This retrospective, single-center study tested the association between FL fluid dynamics and biomechanics and the presence and extent of FL thrombus.

METHODS:

Patients with chronic non-thrombosed or partially thrombosed FLs in the descending aorta after an aortic dissection underwent computed tomography angiography, cardiovascular magnetic resonance (CMR) angiography, and a 4D flow CMR study. A comprehensive quantitative analysis was performed to test the association between FL thrombus presence and extent (percentage of FL with thrombus) and FL anatomy (diameter, entry tear location and size), fluid dynamics (inflow, rotational flow, wall shear stress, kinetic energy, and flow acceleration and stasis), and biomechanics (pulse wave velocity).

RESULTS:

Sixty-eight patients were included. In multivariate logistic regression FL kinetic energy (p = 0.038) discriminated the 33 patients with partial FL thrombosis from the 35 patients with no thrombosis. Similarly, in separated multivariate linear correlations kinetic energy (p = 0.006) and FL inflow (p = 0.002) were independently related to the extent of the thrombus. FL vortexes, flow acceleration and stasis, wall shear stress, and pulse wave velocity showed limited associations with thrombus presence and extent.

CONCLUSION:

In patients with chronic descending aorta dissection, false lumen kinetic energy is related to the presence and extent of false lumen thrombus. CLINICAL RELEVANCE STATEMENT In patients with chronic aortic dissection of the descending aorta, false lumen hemodynamic parameters are closely linked with the presence and extent of false lumen thrombosis, and these non-invasive measures might be important in patient management. KEY POINTS • Partial false lumen thrombosis has been associated with aortic growth in patients with chronic descending aortic dissection; therefore, the identification of prothrombotic flow conditions is desirable. • The presence of partial false lumen thrombosis as well as its extent was related with false lumen kinetic energy. • The assessment of false lumen hemodynamics may be important in the management of patients with chronic aortic dissection of the descending aorta.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Aorta Torácica / Trombosis / Hemodinámica / Disección Aórtica Tipo de estudio: Prognostic_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur Radiol Asunto de la revista: RADIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: España

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Aorta Torácica / Trombosis / Hemodinámica / Disección Aórtica Tipo de estudio: Prognostic_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur Radiol Asunto de la revista: RADIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: España