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3 results for “Type III arch.”
Data set from Marrocco-Trischitta MM, Rylski B, Schofer F, Secchi F, Piffaretti G, de Beaufort H, Belvroy V, Bismuth J, Czerny M, Trimarchi S. Prevalence of type III arch configuration in patients with type B aortic dissection. Eur J Cardiothorac Surg. 2019 Dec 1;56(6):1075-1080. doi: 10.1093/ejcts/ezz137. Erratum in: Eur J Cardiothorac Surg. 2019 Dec 1;56(6):1208. PMID: 31038681.
<p>Data set from Marrocco-Trischitta MM, Rylski B, Schofer F, Secchi F, Piffaretti G, de Beaufort H, Belvroy V, Bismuth J, Czerny M, Trimarchi S. Prevalence of type III arch configuration in patients with type B aortic dissection. Eur J Cardiothorac Surg. 2019 Dec 1;56(6):1075-1080. doi: 10.1093/ejcts/ezz137. Erratum in: Eur J Cardiothorac Surg. 2019 Dec 1;56(6):1208. PMID: 31038681.</p> <p> </p> <p>The abstract:</p> <p><strong>Objectives: </strong>Type III aortic arch configuration consistently presents anatomical and biomechanical characteristics which have been associated with an increased risk of type B aortic dissection (TBD). Our aim was to investigate the prevalence of type III arch in patients with TBD and type B intramural haematoma (IMH-B).</p> <p><strong>Methods: </strong>A multicentre retrospective analysis was performed on patients with TBD and IMH-B observed between 2002 and 2017. The computed tomographic images were reviewed to identify the type of aortic arch. Exclusion criteria included previous arch surgery, presence of aortic dissection or aneurysm proximal to the left subclavian artery and bovine arches. An ad hoc systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to assess the prevalence of type III arch in non-TBD and non-aneurysmal patients.</p> <p><strong>Results: </strong>Two hundred and sixty-one patients with TBD/IMH-B were found to be suitable for the study and were stratified according to aortic arch classification. The ad hoc literature search provided 10 relevant articles, from which a total of 7983 control cases were retrieved. TBD/IMH-B patients were significantly younger than controls [64.3, standard error: 0.74 (62.84-65.76) vs mean pooled age 70.5, standard error: 0.40 (69.71-71.28)]. Patients with TBD/IMH-B presented with a significantly higher prevalence of type III arch [41.0% (107/261) (35.2-47.1)] than controls [16% (1241/7983) (10-22)].</p> <p><strong>Conclusions: </strong>Our data indicate an association between type III arch configuration and the occurrence of TBD/IMH-B. These findings warrant further studies to disclose the potential role of type III arch configuration as an anatomical risk factor for TBD/IMH-B.</p> <p> </p> <p> </p>
Poor concordance between definitions of type III arch and implications for risk prediction and assessment for carotid artery stenting
<p>Dataset from Marrocco-Trischitta MM, Vitale R, Nava G, Baroni I, Boveri S, Nano G, Secchi F. Poor concordance between definitions of type III arch and implications for risk prediction and assessment for carotid artery stenting. J Vasc Surg. 2021 Apr;73(4):1277-1281. doi: 10.1016/j.jvs.2020.08.142. Epub 2020 Sep 25. PMID: 32987147.</p> <p>Abstract</p> <p><strong>Objective: </strong>The type III arch configuration has been inconsistently reported as a stroke risk factor during carotid artery stenting. However, at least three different methods for the definition of type III arch can be identified in the literature, related to the level of the origin of the innominate artery (IA). According to Casserly's definition, a type III arch presents with an origin of the IA below the horizontal plane of the inner curvature. According to Madhwal's definition, a type III arch has a distance greater than twice the diameter of the left common carotid artery between the highest point of the arch and the origin of the IA. According to MacDonald's definition, a type III arch presents with a distance of ≥2 cm between the highest point of the arch and the origin of the IA. Our aim was to assess the level of concordance between these different methods.</p> <p><strong>Methods: </strong>Anonymized thoracic computed tomography scans of 100 healthy patients were reviewed. Two of us independently stratified the selected cases as a type I to III arch, according to the three considered definitions. The interobserver level of concordance for each type III arch classification and level of concordance among the three definitions were assessed.</p> <p><strong>Results: </strong>The 100 selected patients (64% male) were 76 ± 7 years old. For each definition, the interobserver repeatability was almost perfect for all three (Madhwal, κ = 0.81; 95% confidence interval [CI], 0.71-0.99; MacDonald, κ = 0.82; 95% CI, 0.72-0.92; Casserly, κ = 0.84; 95% CI, 0.74-0.93). The level of concordance among the different definitions was very low (Madhwal vs MacDonald, 85% [P = .002]; 33% for type III arch; Madhwal vs Casserly, 60% [P < .0001]; 12% for type III arch; MacDonald vs Casserly, 75% [P < .0001]; 12% for type III arch).</p> <p><strong>Conclusions: </strong>The three definitions of the type III arch have a very low level of concordance, which might account for the varying clinical relevance of this configuration. Our findings have relevant implications for risk prediction for carotid artery stenting based on the presence of a type III arch, for comparisons of the results from different studies, and for comparisons of different datasets from multicenter trials.</p>
Poor concordance between definitions of type III arch and implications for risk prediction and assessment for carotid artery stenting
<p>Dataset from Marrocco-Trischitta MM, Vitale R, Nava G, Baroni I, Boveri S, Nano G, Secchi F. Poor concordance between definitions of type III arch and implications for risk prediction and assessment for carotid artery stenting. J Vasc Surg. 2021 Apr;73(4):1277-1281. doi: 10.1016/j.jvs.2020.08.142. Epub 2020 Sep 25. PMID: 32987147.</p> <p>Abstract</p> <p><strong>Objective: </strong>The type III arch configuration has been inconsistently reported as a stroke risk factor during carotid artery stenting. However, at least three different methods for the definition of type III arch can be identified in the literature, related to the level of the origin of the innominate artery (IA). According to Casserly's definition, a type III arch presents with an origin of the IA below the horizontal plane of the inner curvature. According to Madhwal's definition, a type III arch has a distance greater than twice the diameter of the left common carotid artery between the highest point of the arch and the origin of the IA. According to MacDonald's definition, a type III arch presents with a distance of ≥2 cm between the highest point of the arch and the origin of the IA. Our aim was to assess the level of concordance between these different methods.</p> <p><strong>Methods: </strong>Anonymized thoracic computed tomography scans of 100 healthy patients were reviewed. Two of us independently stratified the selected cases as a type I to III arch, according to the three considered definitions. The interobserver level of concordance for each type III arch classification and level of concordance among the three definitions were assessed.</p> <p><strong>Results: </strong>The 100 selected patients (64% male) were 76 ± 7 years old. For each definition, the interobserver repeatability was almost perfect for all three (Madhwal, κ = 0.81; 95% confidence interval [CI], 0.71-0.99; MacDonald, κ = 0.82; 95% CI, 0.72-0.92; Casserly, κ = 0.84; 95% CI, 0.74-0.93). The level of concordance among the different definitions was very low (Madhwal vs MacDonald, 85% [P = .002]; 33% for type III arch; Madhwal vs Casserly, 60% [P < .0001]; 12% for type III arch; MacDonald vs Casserly, 75% [P < .0001]; 12% for type III arch).</p> <p><strong>Conclusions: </strong>The three definitions of the type III arch have a very low level of concordance, which might account for the varying clinical relevance of this configuration. Our findings have relevant implications for risk prediction for carotid artery stenting based on the presence of a type III arch, for comparisons of the results from different studies, and for comparisons of different datasets from multicenter trials.</p>
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