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General Thoracic and Cardiovascular Surgery

, Volume 67, Issue 1, pp 146–153 | Cite as

The IRAD and beyond: what have we unravelled so far?

  • Xun Yuan
  • Andreas Mitsis
  • Yida Tang
  • Christoph A. NienaberEmail author
SPECIAL EDITION Controversies in Surgery for Thoracic Aorta

Abstract

Acute aortic dissection is a life-threatening condition associated with high morbidity and mortality rates and a long history of challenges to both diagnose and manage this condition successfully. The International Registry of Acute Aortic Dissection (IRAD) was established in 1996 as a global database to understand this old disease better and improve care for dissection. IRAD initially targeted various areas including etiological factors of dissection, modes of presentation, clinical features, physical findings, imaging, management, and outcomes, and is currently branching out in more specific fields such as endovascular intervention, genetic profiling, and functional imaging. Although presenting symptoms and physical findings have not changed significantly over two decades, the widespread use of computed tomography is standard and has improved the diagnostic pathway. Moreover, more patients are managed with appropriate procedures, such as surgery in type A, and endovascular therapy in subsets of type B aortic dissection. With these ongoing improvements in swift diagnostic work-up and therapeutic care, fewer patients are not getting appropriate treatment and more patients survive once they reach hospital.

Keywords

Aortic dissection Imaging techniques Biomarker Cardiovascular surgery Endovascular management 

Notes

Compliance with ethical standards

Conflict of interest

All the authors have declared no competing interest.

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Copyright information

© The Japanese Association for Thoracic Surgery 2017

Authors and Affiliations

  • Xun Yuan
    • 1
  • Andreas Mitsis
    • 1
  • Yida Tang
    • 2
  • Christoph A. Nienaber
    • 1
    Email author
  1. 1.Cardiology and Aortic CentreRoyal Brompton and Harefield NHS Trust and Imperial CollegeLondonUK
  2. 2.Department of Internal Medicine, Coronary Heart Disease Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular DiseaseChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

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