title: Aortic dissection and malperfusion syndrome: a when, what and how-to guide.
abstract: Malperfusion syndrome is a complication of aortic dissection caused by branch-vessel involvement and resulting in end-organ ischaemic dysfunction. Clinical diagnosis is mandatory, and imaging plays a critical role in confirmation and treatment planning. Radiologists must focus on detecting complications (findings of aortic dilation, rupture, organ ischaemia, etc.) and defining vascular compromise and associated malperfusion mechanisms. All these factors guide the multidisciplinary discussion concerning patient management and the suitability of endovascular treatment. Application of dedicated imaging protocols is mandatory in order to answer clinical and anatomical questions. Endovascular therapy has taken a predominant role in the therapeutic management of malperfusion syndrome with aortic fenestration, peripheral stenting and stent-grafting, all of which are procedures within the domain of expertise of current interventional radiologists. The purpose of this editorial is to present a when, what and how-to guide for all radiologists who encounter complicated aortic dissection.
authors.affiliation: Unité Interventionnelle Vasculaire, Service de Radiologie Cardiovasculaire, Hopital Cardiologique, Centre Hospitalier Regional Universitaire de Lille, Blv. du Pr Leclerq, 59037, Lille, France. marco.midulla@chru-lille.fr
authors.forename: M
authors.initials: M
authors.lastname: Midulla
authors.forename: R
authors.initials: R
authors.lastname: Fattori
authors.forename: J-P
authors.initials: JP
authors.lastname: Beregi
authors.forename: M
authors.initials: M
authors.lastname: Dake
authors.forename: H
authors.initials: H
authors.lastname: Rousseau
mesh_terms: D000784:Aortic Dissection / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery*; D000792:Angiography; D017545:Aortic Aneurysm, Thoracic / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D055424:Cardiac-Gated Imaging Techniques; D003287:Contrast Media; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000601:surgery*; D013577:Syndrome; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media