US Duplex Doppler Aorta Abdomen There is no relevant literature regarding the use of duplex US for planning thoracoabdominal aortic endovascular or open repair. Although US can be used to evaluate the abdominal aorta for dissection or aneurysm, limitations to Thoracoabdominal Aortic Aneurysm or Dissection the evaluation of the spatial relationship of the aorta to branch vessels and the inability to visualize portions of the aorta limit its utility as a sole modality for procedural planning. US Echocardiography Transthoracic Resting There is no relevant literature regarding the use of TTE for planning thoracoabdominal aortic endovascular or open repair. Although TTE can evaluate for cardiac complications such as aortic valve regurgitation [33] and evaluate portions of the thoracic aorta, limitations to the evaluation of the spatial relationship of the aorta to branch vessels, the inability to visualize portions of the aorta, and a dependence on operator and patient characteristics limit its utility as a sole modality for procedural planning. Variant 3: Follow-up after endovascular repair of thoracoabdominal aortic aneurysm or dissection. Aortography Chest Abdomen Pelvis Aortogram with DSA for evaluation of the thoracic and abdominal aorta has a sensitivity of up to 90% and a specificity of 95% for acute aortic syndrome [27]. The role of aortography for routine follow-up after endovascular repair is limited in favor of noninvasive modalities such as CTA and MRA, and CTA has been found to have a higher sensitivity than angiogram [75,76]. In cases of increasing aneurysm sac size likely to require treatment of endoleak, aortogram could be considered because it would allow rapid transition from diagnosis to treatment. Additional benefits of angiogram include the ability to evaluate directionality of endoleaks, which can be difficult on CTA [76].
Thoracoabdominal Aneurysm or Dissection Treatment Planning and Follow Up. US Duplex Doppler Aorta Abdomen There is no relevant literature regarding the use of duplex US for planning thoracoabdominal aortic endovascular or open repair. Although US can be used to evaluate the abdominal aorta for dissection or aneurysm, limitations to Thoracoabdominal Aortic Aneurysm or Dissection the evaluation of the spatial relationship of the aorta to branch vessels and the inability to visualize portions of the aorta limit its utility as a sole modality for procedural planning. US Echocardiography Transthoracic Resting There is no relevant literature regarding the use of TTE for planning thoracoabdominal aortic endovascular or open repair. Although TTE can evaluate for cardiac complications such as aortic valve regurgitation [33] and evaluate portions of the thoracic aorta, limitations to the evaluation of the spatial relationship of the aorta to branch vessels, the inability to visualize portions of the aorta, and a dependence on operator and patient characteristics limit its utility as a sole modality for procedural planning. Variant 3: Follow-up after endovascular repair of thoracoabdominal aortic aneurysm or dissection. Aortography Chest Abdomen Pelvis Aortogram with DSA for evaluation of the thoracic and abdominal aorta has a sensitivity of up to 90% and a specificity of 95% for acute aortic syndrome [27]. The role of aortography for routine follow-up after endovascular repair is limited in favor of noninvasive modalities such as CTA and MRA, and CTA has been found to have a higher sensitivity than angiogram [75,76]. In cases of increasing aneurysm sac size likely to require treatment of endoleak, aortogram could be considered because it would allow rapid transition from diagnosis to treatment. Additional benefits of angiogram include the ability to evaluate directionality of endoleaks, which can be difficult on CTA [76].