State-of-the-art aortic imaging: Part II - applications in transcatheter aortic valve replacement and endovascular aortic aneurysm repair.

Rengier, Fabian; Geisbüsch, Philipp; Schoenhagen, Paul; Müller-Eschner, Matthias; Vosshenrich, Rolf; Karmonik, Christof; von Tengg-Kobligk, Hendrik; Partovi, Sasan (2014). State-of-the-art aortic imaging: Part II - applications in transcatheter aortic valve replacement and endovascular aortic aneurysm repair. Vasa - European journal of vascular medicine, 43(1), pp. 6-26. Huber 10.1024/0301-1526/a000324

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Transcatheter aortic valve replacement (TAVR) as well as thoracic and abdominal endovascular aortic repair (TEVAR and EVAR) rely on accurate pre- and postprocedural imaging. This review article discusses the application of imaging, including preprocedural assessment and measurements as well as postprocedural imaging of complications. Furthermore, the exciting perspective of computational fluid dynamics (CFD) based on cross-sectional imaging is presented. TAVR is a minimally invasive alternative for treatment of aortic valve stenosis in patients with high age and multiple comorbidities who cannot undergo traditional open surgical repair. Given the lack of direct visualization during the procedure, pre- and peri-procedural imaging forms an essential part of the intervention. Computed tomography angiography (CTA) is the imaging modality of choice for preprocedural planning. Routine postprocedural follow-up is performed by echocardiography to confirm treatment success and detect complications. EVAR and TEVAR are minimally invasive alternatives to open surgical repair of aortic pathologies. CTA constitutes the preferred imaging modality for both preoperative planning and postoperative follow-up including detection of endoleaks. Magnetic resonance imaging is an excellent alternative to CT for postoperative follow-up, and is especially beneficial for younger patients given the lack of radiation. Ultrasound is applied in screening and postoperative follow-up of abdominal aortic aneurysms, but cross-sectional imaging is required once abnormalities are detected. Contrast-enhanced ultrasound may be as sensitive as CTA in detecting endoleaks.

Item Type:	Journal Article (Review Article)
Division/Institute:	04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology
UniBE Contributor:	von Tengg-Kobligk, Hendrik
Subjects:	600 Technology > 610 Medicine & health
ISSN:	0301-1526
Publisher:	Huber
Language:	English
Submitter:	Aisha Stefania Mzinga
Date Deposited:	25 Sep 2014 14:11
Last Modified:	05 Dec 2022 14:34
Publisher DOI:	10.1024/0301-1526/a000324
PubMed ID:	24429327
Uncontrolled Keywords:	Aorta angiography aortic diseases computed tomography imaging magnetic resonance imaging
URI:	https://boris.unibe.ch/id/eprint/52298