Monitoring

Imaging of the aorta should be performed before discharge.[23] The time intervals suggested for surveillance imaging with computed tomography angiography (CTA) or magnetic resonance angiography (MRA) in patients with chronic aortic dissection vary across guidelines and should be tailored for individual patients.[23]

The American Heart Association notes that several reasonable follow-up regimens have been proposed for different treatment groups.[23] After surgical repair, patients should be followed up after 6 and 12 months, and annually thereafter.[23] If a moderate-sized aneurysm remains relatively stable over time, subsequent longer follow-up intervals of 1.5 to 3 years are reasonable. In medically managed uncomplicated type B dissection, one additional earlier scan, for example, at 3 months, may reveal important changes occurring in the subacute phase, when the dissected aorta remains amenable to early thoracic endovascular aortic repair (TEVAR). Earlier follow-up imaging at 30 days is sometimes recommended to identify potential early complications, followed by routine 6-month and 12-month follow-up.[23][77]​ Continued annual imaging is suggested thereafter. If growth or other complications are detected, shorter follow-up intervals may be required in all treatment groups.[4][23]​ CTA is recommended as the imaging of choice for follow-up of patients who have undergone TEVAR.[23] However, magnetic resonance imaging (MRI) is preferred in younger patients to reduce radiation exposure.[13]

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