Intra-aortic haemodynamics in aortic dissection
Research type
Research Study
Full title
An investigation of intra-aortic haemodynamics in aortic dissection
IRAS ID
140103
Contact name
Peter Taylor
Contact email
Sponsor organisation
King's College London
Research summary
The aorta is the largest blood vessel in the body, channelling blood from the heart to all organs. Aortic dissection is a life threatening condition where a tear develops in the inner lining of the aorta, forming an additional false channel (lumen) for blood flow. As a result, blood flow in the true channel may be compromised affecting the viability of organs.
Patient management depends largely on the location of the tear and the presence of complicating factors such as persistent chest pain due to ongoing aortic enlargement (as a result of an increase in the size of the false lumen), compromised blood supply to organs and rupture of the aorta. Patients who remain stable undergo regular imaging, looking for changes in aortic size. When the changes in size are deemed significant, surgical intervention in the form of endovascular stent-graft insertion is considered.
Patients have variable outcomes despite best medical and surgical care and those with apparently similar types of dissection anatomy present very different long-term outcomes. Unsurprisingly, managing these patients is difficult. A patient-specific method for treatment planning would provide a superior modality of care.
Although false lumen haemodynamics (blood pressure, blood velocity and wall shear stress) are thought to be responsible for complications, no study has proven this. We aim to develop an entirely non-invasive, tailor-made method to study aortic conditions using a combination of computed tomography (CT) and magnetic resonance (MR) imaging and computer simulation techniques. This method will provide an accurate tool to assess these patients on follow-up, allowing for tailor made care.
In the first instance, a pilot comparison study between non-invasive (simulated) and invasive haemodynamics (measured) will have to be made to validate the newer non-invasive techniques. We propose to undertake this validation study by performing invasive aortic readings using pressure catheters at the same time as the patients are undergoing a planned surgical intervention to treat their dissection (stent-graft insertion).REC name
London - Bromley Research Ethics Committee
REC reference
14/LO/0286
Date of REC Opinion
26 Feb 2014
REC opinion
Favourable Opinion