Cross-Sectional Imaging Studies: What Can We Learn and What Do We Need to Know?

Virtual angioscopy assessment for acute type B aortic dissection endovascular repair

INTRODUCTION

Virtual angioscopy 3D reconstruction (VA) based on Multidetector computed tomography (m-CT) can be an important tool in endovascular aortic repair assessment. Here, we present a case of an acute type B aortic dissection, evaluated with preoperative virtual angioscopy 3D reconstruction (VA).

CASE REPORT

A 60 years-old-man presented with type B acute aortic dissection. Due to renal malperfusion and uncontrolled hypertension TEVAR and renal stenting was performed based on m-CT and VA images.

DISCUSSION

Aortic dissection endovascular repair requires an accurate evaluation based on M-CT or magnetic resonance angiography (MRA). VA is a CT-based 3D reconstruction that provides a sort of information comparable to intravascular ultrasound (IVUS) that can be very helpful when it is not available and has many other potential applications in vascular surgery.

Endovascular image-guided interventions (EIGIs)

Minimally invasive interventions are rapidly replacing invasive surgical procedures for the most prevalent human disease conditions. X-ray image-guided interventions carried out using the insertion and navigation of catheters through the vasculature are increasing in number and sophistication. In this article, we offer our vision for the future of this dynamic field of endovascular image-guided interventions in the form of predictions about (1) improvements in high-resolution detectors for more accurate guidance, (2) the implementation of high-resolution region of interest computed tomography for evaluation and planning, (3) the implementation of dose tracking systems to control patient radiation risk, (4) the development of increasingly sophisticated interventional devices, (5) the use of quantitative treatment planning with patient-specific computer fluid dynamic simulations, and (6) the new expanding role of the medical physicist. We discuss how we envision our predictions will come to fruition and result in the universal goal of improved patient care.