2020
Implementation of an aortic dissection CT protocol with clinical decision support aimed at decreasing radiation exposure by reducing routine abdominopelvic imaging
Patel V, Fruauff A, Esses D, Lipsitz E, Levsky J, Haramati L. Implementation of an aortic dissection CT protocol with clinical decision support aimed at decreasing radiation exposure by reducing routine abdominopelvic imaging. Clinical Imaging 2020, 67: 108-112. PMID: 32559680, DOI: 10.1016/j.clinimag.2020.06.005.Peer-Reviewed Original ResearchConceptsAcute aortic syndromeAortic dissectionAortic syndromeClinical decision supportED patientsChest/abdomen/pelvisRadiation doseDiagnostic accuracyStudy periodTotal ED populationMedian radiation doseAbdomen/pelvisRoutine abdominopelvicVs. 3.7ED populationContrast doseDiagnostic yieldRetrospective analysisCT scanCT protocolPatientsDissectionRadiation exposureDoseScreening protocol
2017
Prospective study of a non-restrictive decision rule for acute aortic syndrome
Goldschmiedt J, Levsky J, Bellin E, Mizrachi E, Esses D, Haramati L. Prospective study of a non-restrictive decision rule for acute aortic syndrome. The American Journal Of Emergency Medicine 2017, 35: 1309-1313. PMID: 28427782, DOI: 10.1016/j.ajem.2017.04.014.Peer-Reviewed Original ResearchConceptsAcute aortic syndromeClinical decision ruleEmergency department patientsCT utilization ratesDepartment patientsAortic syndromeCT utilizationMean effective radiation doseRisk-stratify patientsHigh-risk groupDose reduction protocolResults of CTEffective radiation doseQuality improvement measuresAortic surgeryProspective cohortDerivation cohortHistoric cohortStudy cohortProspective studyAcute traumaSafe decreaseDiagnostic yieldPatientsClinical decision
2014
Can non-contrast-enhanced CT (NECT) triage patients suspected of having non-traumatic acute aortic syndromes (AAS)?
Vantine P, Rosenblum J, Schaeffer W, Williams K, Dockray D, Levsky J, Haramati L, Ketai L. Can non-contrast-enhanced CT (NECT) triage patients suspected of having non-traumatic acute aortic syndromes (AAS)? Emergency Radiology 2014, 22: 19-24. PMID: 24939821, DOI: 10.1007/s10140-014-1239-8.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAdultAgedAged, 80 and overAortic DiseasesContrast MediaDecision Support TechniquesDiagnosis, DifferentialHumansIohexolIopamidolMiddle AgedRadiographic Image Interpretation, Computer-AssistedRetrospective StudiesSensitivity and SpecificitySyndromeTomography, X-Ray ComputedTriageConceptsAcute aortic syndromeContrast-enhanced CT angiographyAortic diameterAortic syndromeNegative casesCTA resultsAbnormal aortic contourLower likelihoodMaximal aortic diameterIndependent positive predictorsCT of patientsLogistic regression analysisSecond institutionNegative predictive valueMean sensitivityDerivation phaseIndependent predictorsAortic diseaseTriage patientsAortic contourCT angiographyAortic wallPatientsPositive diagnosisPredictive value
2013
Preliminary development of a clinical decision rule for acute aortic syndromes
Lovy A, Bellin E, Levsky J, Esses D, Haramati L. Preliminary development of a clinical decision rule for acute aortic syndromes. The American Journal Of Emergency Medicine 2013, 31: 1546-1550. PMID: 24055476, PMCID: PMC4275798, DOI: 10.1016/j.ajem.2013.06.005.Peer-Reviewed Original ResearchConceptsAcute aortic syndromeClinical decision ruleAcute chest painAbnormal chest radiographAortic syndromeChest painEmergency departmentChest radiographsRetrospective case-control reviewLow-risk patientsCase-control reviewNegative predictive valueAtherosclerotic ulcerIntramural hematomaOngoing painED presentationsAortic dissectionRisk factorsCT usageInclusion criteriaCT angiographyLower riskDiagnostic criteriaPatientsPrior traumaAcute aortic syndromes: a second look at dual-phase CT.
Lovy A, Rosenblum J, Levsky J, Godelman A, Zalta B, Jain V, Haramati L. Acute aortic syndromes: a second look at dual-phase CT. American Journal Of Roentgenology 2013, 200: 805-11. PMID: 23521452, PMCID: PMC3685820, DOI: 10.2214/ajr.12.8797.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedAged, 80 and overAortic DiseasesAortographyCase-Control StudiesChi-Square DistributionContrast MediaFemaleHumansIohexolLinear ModelsMaleMiddle AgedRadiation DosageRetrospective StudiesSensitivity and SpecificityStatistics, NonparametricSyndromeTomography, X-Ray ComputedTriiodobenzoic AcidsConceptsAcute aortic syndromeContrast-enhanced CTAAortic syndromeIntramural hematomaUnenhanced CTControl subjectsMore CT findingsType B dissectionCT dose length productHealthy control subjectsContrast-enhanced CTDose-length productDual-phase CTRadiation effective doseContrast-enhanced phasesMean radiation effective doseAtherosclerotic ulcerB dissectionAortic dissectionAortic ruptureCase patientsCT findingsEmergency departmentCTA examinationsStudy population