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array:24 [ "pii" => "S2173510723000319" "issn" => "21735107" "doi" => "10.1016/j.rxeng.2022.11.003" "estado" => "S300" "fechaPublicacion" => "2023-03-01" "aid" => "1442" "copyright" => "SERAM" "copyrightAnyo" => "2022" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Radiologia. 2023;65 Supl 1:S53-S62" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S003383382200251X" "issn" => "00338338" "doi" => "10.1016/j.rx.2022.11.004" "estado" => "S300" "fechaPublicacion" => "2023-03-01" "aid" => "1442" "copyright" => "SERAM" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Radiologia. 2023;65 Supl 1:S53-S62" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:12 [ "idiomaDefecto" => true "titulo" => "Aneurisma de aorta abdominal roto, ¿qué necesitan el radiólogo intervencionista y el cirujano vascular de nuestro informe?" 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Lojo-Lendoiro, P. Calvín Álvarez, P. Sobral Viñas" "autores" => array:3 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Lojo-Lendoiro" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "Calvín Álvarez" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Sobral Viñas" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173510723000319" "doi" => "10.1016/j.rxeng.2022.11.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510723000319?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S003383382200251X?idApp=UINPBA00004N" "url" => "/00338338/00000065000000S1/v1_202303211149/S003383382200251X/v1_202303211149/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173510723000356" "issn" => "21735107" "doi" => "10.1016/j.rxeng.2022.09.013" "estado" => "S300" "fechaPublicacion" => "2023-03-01" "aid" => "1425" "copyright" => "SERAM" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Radiologia. 2023;65 Supl 1:S63-S72" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "titulo" => "Schematic approach to the diagnosis of multifocal lung opacities in the emergency department" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "S63" "paginaFinal" => "S72" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Abordaje esquemático del diagnóstico de las opacidades pulmonares multifocales en la urgencia" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 3550 "Ancho" => 2508 "Tamanyo" => 769382 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0160" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Multifocal pulmonary opacities with a predominantly central distribution.</p> <p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Acute cardiogenic pulmonary edema on radiography. a) Incipient alveolar phase, with signs of increased blood volume (dilation of veins [black arrow] and pulmonary arteries [white arrow], and increased cardiothoracic ratio), interstitial edema (thickening of peribronchovascular cuffs [white arrowhead] and Kerley B lines [black arrowheads]) and alveolar edema, with small central consolidation in the right upper lobe (asterisk). b) More evolved alveolar phase in another patient, with perihilar consolidations with butterfly wings pattern.</p> <p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Diffuse alveolar hemorrhage in a patient with Goodpasture syndrome on X-ray (c) and computed tomography (d), with predominantly mid-to-basal central consolidations, ground-glass opacities, and reticulation, with subpleural respect.</p> <p id="spar0040" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Pneumocystis jirovecii</span> pneumonia in an HIV-positive patient diagnosed a posteriori, with central opacities predominantly in upper regions, mainly ground glass, on X-ray (e). In another patient, subjected to high doses of corticosteroids for a brain tumor, a more serious involvement was observed, with greater extension and density of the opacities, predominantly in ground glass and in upper regions, with subpleural sparing, in the computed tomography (f).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.M. Plasencia Martínez" "autores" => array:1 [ 0 => array:2 [ "nombre" => "J.M." "apellidos" => "Plasencia Martínez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0033833822002259" "doi" => "10.1016/j.rx.2022.09.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0033833822002259?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510723000356?idApp=UINPBA00004N" "url" => "/21735107/00000065000000S1/v2_202304071829/S2173510723000356/v2_202304071829/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173510723000198" "issn" => "21735107" "doi" => "10.1016/j.rxeng.2022.09.009" "estado" => "S300" "fechaPublicacion" => "2023-03-01" "aid" => "1417" "copyright" => "SERAM" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Radiologia. 2023;65 Supl 1:S42-S52" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "titulo" => "Fractures of the limbs: basic concepts for the emergency department" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "S42" "paginaFinal" => "S52" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Fracturas de las extremidades: conceptos básicos para la urgencia" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0030" "etiqueta" => "Figure 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 2862 "Ancho" => 3352 "Tamanyo" => 686961 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0030" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">(A–C) Dislocated knee with contained rupture of the popliteal artery in a young patient after a motorcycle accident. Anterior-posterior X-ray (A) shows increased medial tibiofemoral joint space and adjacent soft tissue; in the lateral X-ray (B), joint effusion can be seen (arrow). There is no visible dislocation, as they are usually reduced with immobilisation in immediate trauma care, so we have to be alert to subtle abnormalities. Sagittal CT-angiography MIP (maximum intensity projection) reconstruction (C): shows a contained rupture of the popliteal artery (arrowhead) with threadlike distal vessels. (D–F) Sanders classification of intra-articular fractures of the calcaneus (D). It is based on CT assessment of the posterior articular facet (thalamus) in a plane coronal to the posterior subtalar joint. (E) Sanders type I fracture. Although there are two joint fragments separated by a type B fracture line, there is no displacement or depression >2 mm. (E) Sanders type III AC fracture. Three joint fragments can be seen; the middle fragment (star) was depressed in a plane posterior to that shown.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Blanco-Barrio, A. Moreno-Pastor, M. Lozano-Ros" "autores" => array:3 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Blanco-Barrio" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Moreno-Pastor" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Lozano-Ros" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0033833822002028" "doi" => "10.1016/j.rx.2022.09.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0033833822002028?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510723000198?idApp=UINPBA00004N" "url" => "/21735107/00000065000000S1/v2_202304071829/S2173510723000198/v2_202304071829/en/main.assets" ] "en" => array:18 [ "idiomaDefecto" => true "titulo" => "Ruptured abdominal aortic aneurysm, what does the interventional radiologist and vascular surgeon need from our report?" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "S53" "paginaFinal" => "S62" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "S. Lojo-Lendoiro, P. Calvín Álvarez, P. Sobral Viñas" "autores" => array:3 [ 0 => array:4 [ "nombre" => "S." "apellidos" => "Lojo-Lendoiro" "email" => array:1 [ 0 => "sara.lojo.lendoiro@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "P." "apellidos" => "Calvín Álvarez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "P." "apellidos" => "Sobral Viñas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Sección de Radiología Vascular Intervencionista, Servicio de Radiodiagnóstico, Hospital Ribera-POVISA, Vigo, Pontevedra, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Angiología y Cirugía Vascular, Hospital Ribera-POVISA, Vigo, Pontevedra, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Radiodiagnóstico, Hospital Ribera-POVISA, Vigo, Pontevedra, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Aneurisma de aorta abdominal roto, ¿qué necesitan el radiólogo intervencionista y el cirujano vascular de nuestro informe?" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1803 "Ancho" => 2925 "Tamanyo" => 451875 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Measurements necessary for EVAR planning.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The prevalence of abdominal aortic aneurysm (AAA) in the general population is 1–1.5 cases per 100 people. It continues to be a significant cause of morbidity and mortality; 1–2% of all deaths in the Western world are from a ruptured aneurysm and it is the tenth leading cause of death in the over-55s in the United States.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The development of an AAA is a silent process that gradually progresses until it ruptures, often with a fatal outcome. With a diameter of 4−5<span class="elsevierStyleHsp" style=""></span>cm, the risk of rupture is 14%, increasing to 10% when the aneurysm reaches a diameter of 5−6<span class="elsevierStyleHsp" style=""></span>cm. According to the literature, this disease would seem to meet the criteria for a population screening programme with the aim of reducing death directly attributable to the aneurysm.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> A number of clinical studies have concluded that population screening would be effective in certain healthcare economies (United Kingdom, Sweden and Denmark), but it would take up to 10 years to gather the necessary scientific evidence to support its implementation.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> While AAA rupture has a mortality rate of 85–90%, the mortality rate for elective treatment of aneurysm is less than 3–5%.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Up to 75% of AAAs are asymptomatic<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and in many cases the first evidence of aneurysm is when it ruptures and the patient ends up in hospital with acute symptoms. The management of AAA has fundamentally changed over the last thirty years, from open surgery as the only option, to the introduction of the endovascular aortic aneurysm repair (EVAR) technique. Parodi successfully treated the first EVAR case in history in Buenos Aires in September 1990.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">With the introduction of EVAR and improvements in anaesthetic and perioperative management, the survival of treated patients has increased. EVAR has made repair possible in older patients or patients whose degree of comorbidity contraindicated open surgery, and nowadays the perioperative mortality rate among octogenarians is comparable to that of younger patients.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">For decision-making in the management of these patients, the work of the radiologist forms an essential part and a precise and specific report is therefore of vital importance. The aim of this article is to provide guidance for writing the radiological report.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Open surgery or EVAR</span><p id="par0030" class="elsevierStylePara elsevierViewall">The clinical presentation of a ruptured AAA (rAAA) is often subtle and confusing, with signs ranging from syncope, loss of consciousness or transient hypotension to simple backache. The classic triad is abdominal or low back pain, hypotension and a pulsatile abdominal mass, although these signs are only present in 25–50% of patients.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11–14</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The gold standard as imaging test for suspected rAAA is currently computed tomography (CT). An abdominal and pelvic CT angiogram with 1-mm slice thickness will provide sufficient information to determine whether or not the patient is a candidate for EVAR and, if so, obtain the necessary measurements for planning the procedure. This scan should be performed in stable patients (class I recommendation, level of evidence B) and even considered in haemodynamically unstable patients (class II recommendation, level of evidence B).<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> In emergency cases, the patient should be taken to the operating theatre immediately for open surgery or intraoperative aortography to determine the feasibility of performing an EVAR.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">The IMPROVE trial,<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> which compared the two techniques, found no differences in the mortality rate at 30 days (35% EVAR, 37% open surgery) or at one year. It did demonstrate better quality of life, decreased hospital stay and cost, and better three-year survival with endovascular treatment, and similar levels of re-operation in both techniques. Currently, the European and American guidelines<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16,17</span></a> recommend endovascular treatment whenever anatomically feasible, with level of evidence B (moderate, European guidelines) and C (low, American guidelines). The NICE guidelines<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> (United Kingdom) determine that EVAR provides a greater benefit for most patients, especially men over the age of 70 and women in any age range, while open surgery boasts a greater benefit-risk balance in under-70<span class="elsevierStyleHsp" style=""></span>s. EVAR is associated with a decrease in early death, but this benefit is not maintained in the medium and long term due to the development of complications.</p><p id="par0045" class="elsevierStylePara elsevierViewall">For all these reasons, the decision to perform EVAR routinely is not recommended, even if it is feasible. Rather, this decision will depend on the patient's age, comorbidities, previous abdominal surgery, anatomical considerations and the experience of the working team.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Types of EVAR</span><p id="par0050" class="elsevierStylePara elsevierViewall">Standard EVAR: aortic prosthetic endografts, typically consisting of two components: a bifurcated body and extensions. Polytetrafluoroethylene (PTFE, registered as TeflonTM) prosthetic fabric is sewn to a metal support structure using non-absorbable sutures of braided polyester, monofilament polypropylene or laminated fluoroethylene-propylene/expanded PTFE. The support stents are made of nitinol or stainless steel wire. They usually have radiopaque markings to enable their position to be checked once placed.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Chimney EVAR (CHEVAR): emerged as a rescue technique making it possible to maintain visceral branches that would be occluded with the placement of the endograft body.</p><p id="par0060" class="elsevierStylePara elsevierViewall">A conventional endograft is overlapped over coated stents, which are placed in the visceral branches or renal arteries, in order to maintain their patency while achieving an optimal seal zone.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Fenestrated endografts (FEVAR): there are certain limitations with conventional stent grafts in the case of a juxtarenal or adrenal aneurysm, where there is no healthy area of the aortic wall to support the device stents. Fenestrated endografts have been developed for that purpose. These grafts have holes in the body, corresponding to the ostia of the visceral arteries and renal arteries involved in the aneurysm, in order to prevent them from becoming occluded. After placement of the fenestrated body, the covered stent is placed in the corresponding artery. These grafts are custom-made, adjusting to the individual anatomical requirements of each patient, so they would not be available for an urgent case.</p><p id="par0070" class="elsevierStylePara elsevierViewall">Branched endografts (BEVAR): this is a main graft body to which secondary grafts (coated stents) are added through which the different arteries involved in the aneurysm are channelled. Within this group, there are grafts with branches external to the main body and, more recently, grafts with internal branches have been developed. There is currently a non-customised endograft with internal branches on the market that could be an effective alternative for a wide range of patients with rAAA who are not eligible for standard EVAR. For the moment, however, prospective studies are needed to determine its suitability (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Radiology report</span><p id="par0075" class="elsevierStylePara elsevierViewall">Whether the rAAA is to be treated by open surgery or endovascular repair, there are some essential elements that have to be systematically reflected in the diagnostic report to describe the findings. However, this article focuses on endovascular repair, as this is where the radiology report has to be more specific.</p><p id="par0080" class="elsevierStylePara elsevierViewall">The first important aspect is to identify the ruptured aortic aneurysm itself or, if it is not ruptured, signs of imminent rupture. Clinical suspicion can be helpful in making the diagnosis and, in this case, as pain is a sign associated with aneurysm expansion and rupture, the presence of pain <span class="elsevierStyleItalic">per se</span> in association with an abdominal aneurysm increases the patient's morbidity and mortality risk.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">There are various radiological signs that are helpful in diagnosing an imminent rupture, an already ruptured and bleeding aneurysm, or a chronic or contained rupture (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Location</span><p id="par0090" class="elsevierStylePara elsevierViewall">The location of the aneurysm is fundamental as it will determine the choice of graft. Aneurysms are most often located between the renal arteries and the aortoiliac bifurcation. Approximately 5% of cases will compromise the visceral branches.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">It is necessary to assess the number and location of visceral arteries involved in the abdominal aneurysmal sac. Essentially, we will see that the inferior mesenteric artery originates from the sac wall and will be excluded both in open surgery and with the implantation of the graft body. Thanks to the collateral circulation coming from the arc of Riolan, in most cases this will not have any clinical implications (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">Infrarenal: the AAA is located below the origin of both renal arteries. In this case, it is necessary to know the distance from the lowest renal artery to the beginning of the aneurysmal sac and also to know whether or not this space, called the neck, has a healthy aortic wall (free of thrombus and atheromatous plaques), as this is where the stent for fixation of the endograft body will be anchored. It is important to know the shape of the neck of the aneurysm (for example, whether it is conical or inverted conical, its angle with respect to the axis of the aorta) and the diameter. Based on the specifications for use of the different devices, the treatment range is from 18 to 32<span class="elsevierStyleHsp" style=""></span>mm. However, a diameter greater than 28<span class="elsevierStyleHsp" style=""></span>mm increases the risk of associated complications.</p><p id="par0105" class="elsevierStylePara elsevierViewall">At this point we have to be aware of the concept of <span class="elsevierStyleItalic">hostile neck</span>.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> This term refers to aneurysm necks that meet some or all of the following criteria:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0110" class="elsevierStylePara elsevierViewall">Length of 15 to 10<span class="elsevierStyleHsp" style=""></span>mm.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0115" class="elsevierStylePara elsevierViewall">Diameter greater than 28<span class="elsevierStyleHsp" style=""></span>mm.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">-</span><p id="par0120" class="elsevierStylePara elsevierViewall">Angulation greater than 60°.</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">-</span><p id="par0125" class="elsevierStylePara elsevierViewall">Calcification of the aortic wall greater than 50%.</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">-</span><p id="par0130" class="elsevierStylePara elsevierViewall">Circumferential thrombus.</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">-</span><p id="par0135" class="elsevierStylePara elsevierViewall">Conical shape.</p></li></ul></p><p id="par0140" class="elsevierStylePara elsevierViewall">When measuring the neck of the aneurysm, there are two important angles:<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">-</span><p id="par0145" class="elsevierStylePara elsevierViewall">The alpha/α angle or suprarenal angle: this is the angle formed between the central axis of the suprarenal aorta and the proximal neck of the aneurysm.</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">-</span><p id="par0150" class="elsevierStylePara elsevierViewall">The beta/β angle or infrarenal angle: formed between the axis of the proximal neck and the axis of the lumen of the aneurysmal sac. We are always referring to this β angle when we state that the angulation of the aneurysmal sac with respect to the axis of the abdominal aorta should be <60°.</p></li></ul></p><p id="par0155" class="elsevierStylePara elsevierViewall">Juxtarenal: if the AAA begins infrarenally but the distance from the lowest renal artery to the sac is less than 15<span class="elsevierStyleHsp" style=""></span>mm in length, the length may not be adequate for fixation of the body of the stent. There are occasions when the instructions for use of the devices are not strictly adhered to, with standard EVAR being performed in necks of up to 10<span class="elsevierStyleHsp" style=""></span>mm. If this is not possible, endovascular repair using the CHEVAR technique or open surgery would have to be considered.</p><p id="par0160" class="elsevierStylePara elsevierViewall">Para/suprarenal: the aneurysmal sac includes both renal arteries, and may also include the outlet of the coeliac trunk and the superior mesenteric artery (SMA). In this case, the options are the placement of a chimney graft or open surgery (aneurysm resection and graft interposition and re-implantation or bypass of all the arterial branches involved).</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Sac</span><p id="par0165" class="elsevierStylePara elsevierViewall">We have to indicate the size of the sac, whether there is a mural thrombus and, if so, whether or not the distribution is concentric and how much lumen is left for blood to flow through. It is essential to assess the angulation of the aneurysmal sac with respect to the axis of the abdominal aorta, with the recommendation being for angulations of less than 60° in EVAR.</p><p id="par0170" class="elsevierStylePara elsevierViewall">The length of the sac has to be determined, indicating where it begins (para/supra/juxta or infrarenal) and where it ends, and if it includes the iliac bifurcation caudally.</p><p id="par0175" class="elsevierStylePara elsevierViewall">The aneurysmal sac may be fusiform, the most common, or have a saccular or “hourglass” shape. Mycotic or inflammatory aneurysms can appear as a thickening of the aortic wall; the fibrotic appearance, a peri-aortic striation or an atypically located focal saccular aneurysm should raise the suspicion of a mycotic aneurysm or aneurysm secondary to an inflammatory process, which have a greater risk of rupture (53–75%).<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> The treatment must be carefully assessed as, if performing an EVAR (graft material which is a foreign body), any underlying infectious/inflammatory process has to be taken into account.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Aortic conus</span><p id="par0180" class="elsevierStylePara elsevierViewall">Diameter of distal neck. In cases with a distal aortic neck of less than 18<span class="elsevierStyleHsp" style=""></span>mm, placement of an aorto-uni-iliac stent graft should be considered.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Arterial access</span><p id="par0185" class="elsevierStylePara elsevierViewall">Repair using the EVAR technique will be performed using femoral arterial approaches, so knowing the status of the femoral and iliac arteries is vital. We have to report the morphology and maximum and mean diameter of the arteries on both sides; whether there is occlusion or stenosis of the arterial lumen and, if so, what the smallest diameter is.</p><p id="par0190" class="elsevierStylePara elsevierViewall">We also have to report whether or not both hypogastric arteries are patent.</p><p id="par0195" class="elsevierStylePara elsevierViewall">The optimal conditions are that both common iliac arteries have a length of at least 15<span class="elsevierStyleHsp" style=""></span>mm prior to their bifurcation to obtain a good seal length, and that they have a diameter between 8 and 22<span class="elsevierStyleHsp" style=""></span>mm.</p><p id="par0200" class="elsevierStylePara elsevierViewall">Also important is the concept of <span class="elsevierStyleItalic">hostile iliacs</span>:<ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">-</span><p id="par0205" class="elsevierStylePara elsevierViewall">Excessive angulation.</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">-</span><p id="par0210" class="elsevierStylePara elsevierViewall">Severe diffuse atheromatous disease causing stenosis.</p></li><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">-</span><p id="par0215" class="elsevierStylePara elsevierViewall">Aneurysmal common iliac arteries: in such cases, embolisation of the ipsilateral hypogastric artery is usually required during the procedure to achieve distal sealing in the external iliac artery.</p></li></ul></p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Other considerations</span><p id="par0380" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0020"><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">-</span><p id="par0220" class="elsevierStylePara elsevierViewall">Anatomical variants: retroaortic or circumaortic renal veins.</p></li><li class="elsevierStyleListItem" id="lsti0065"><span class="elsevierStyleLabel">-</span><p id="par0225" class="elsevierStylePara elsevierViewall">Existence of renal polar arteries, stating the location of their origin in the report.</p></li><li class="elsevierStyleListItem" id="lsti0070"><span class="elsevierStyleLabel">-</span><p id="par0230" class="elsevierStylePara elsevierViewall">Arterial stenosis: can risk organ viability and even be life-threatening for the patient. The pre-existence of stenosis in the coeliac trunk, the SMA or the renal arteries is particularly important if the repair is with the CHEVAR technique, where these arteries are going to be manipulated endovascularly.</p></li><li class="elsevierStyleListItem" id="lsti0075"><span class="elsevierStyleLabel">-</span><p id="par0235" class="elsevierStylePara elsevierViewall">Existence of visceral aneurysms.</p></li><li class="elsevierStyleListItem" id="lsti0080"><span class="elsevierStyleLabel">-</span><p id="par0240" class="elsevierStylePara elsevierViewall">Existence of hypertrophic lumbar arteries, which can lead to type II endoleaks.</p></li><li class="elsevierStyleListItem" id="lsti0085"><span class="elsevierStyleLabel">-</span><p id="par0245" class="elsevierStylePara elsevierViewall">Unknown concomitant processes: we must highlight space-occupying lesions or complications deriving from an abdominal oncological or infectious process.</p></li><li class="elsevierStyleListItem" id="lsti0090"><span class="elsevierStyleLabel">-</span><p id="par0250" class="elsevierStylePara elsevierViewall">In the case of open surgery, the report should also include evidence of previous abdominal surgery, a factor that increases the morbidity risk attached to the procedure.</p></li></ul></p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Measurements</span><p id="par0255" class="elsevierStylePara elsevierViewall">An AAA is considered when the diameter of the aorta exceeds 3<span class="elsevierStyleHsp" style=""></span>cm. A 7-cm aneurysm carries a 25% risk per year of rupture.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> Although not necessary for us to determine this, if the point of rupture of the aneurysm is sought, the majority occur on the posterior-lateral aspect.</p><p id="par0260" class="elsevierStylePara elsevierViewall">If repair using the EVAR technique is to be performed, there is a series of measurements that must be assessed, including what type of graft to use and with what dimensions.</p><p id="par0265" class="elsevierStylePara elsevierViewall">It is essential when performing an aortic measurement, particularly when we need to assess an aneurysm's growth or establish the dimensions in an EVAR, that each measurement is made orthogonal to the variable axis of the aorta in each plane. This means that for each measurement, we have to angulate the aortic axis in the three spatial planes, as this provides real measurements of the dimensions (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0270" class="elsevierStylePara elsevierViewall">We should also highlight the concepts of multiplanar reconstruction (MPR), which involves two-dimensional images in multiple planes with maximum intensity projection, enabling a more precise analysis of the vessel wall and calcium distribution (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><p id="par0275" class="elsevierStylePara elsevierViewall">There is a tool in the reconstruction of the images that is part of the curved MPR analysis called the central lumen line. The aim is to virtually recreate the aneurysm stretched along the central axis of the lumen of the vessel. This is a useful tool, as it measures diameters, but it remains an automatic software measurement, which means there is the potential for error. The estimated lengths and diameters may not coincide with the final lengths of the artery, so it is always recommended to verify them manually to ensure precision when choosing the graft material.</p><p id="par0280" class="elsevierStylePara elsevierViewall">The measurements required for planning an EVAR are shown in the diagram in <a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>; they will be made by the doctor in charge of the surgery, for choosing the type and size of each graft (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>).</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0285" class="elsevierStylePara elsevierViewall">From among these, there are some basic data that should be provided in the report:<ul class="elsevierStyleList" id="lis0025"><li class="elsevierStyleListItem" id="lsti0095"><span class="elsevierStyleLabel">-</span><p id="par0290" class="elsevierStylePara elsevierViewall">D2: infrarenal neck diameter.</p></li><li class="elsevierStyleListItem" id="lsti0100"><span class="elsevierStyleLabel">-</span><p id="par0295" class="elsevierStylePara elsevierViewall">D7: diameter of the aorta prior to the bifurcation.</p></li><li class="elsevierStyleListItem" id="lsti0105"><span class="elsevierStyleLabel">-</span><p id="par0300" class="elsevierStylePara elsevierViewall">D8: diameter of both common iliac arteries.</p></li><li class="elsevierStyleListItem" id="lsti0110"><span class="elsevierStyleLabel">-</span><p id="par0305" class="elsevierStylePara elsevierViewall">D9: diameter of both external iliac arteries.</p></li><li class="elsevierStyleListItem" id="lsti0115"><span class="elsevierStyleLabel">-</span><p id="par0310" class="elsevierStylePara elsevierViewall">Diameter of both common femoral arteries.</p></li></ul></p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Proposal for structured report</span><p id="par0315" class="elsevierStylePara elsevierViewall">Decision-making in cases of rAAA must be systematic and as rapid as possible. We therefore have to be clear about the morphology of the aneurysm, as this will determine the type of intervention and the type of graft. For the purposes of facilitating and describing in clear, simple terms the findings of the abdominal CT, we have created the framework for a predefined report,<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21,23</span></a> which collates the necessary data in structured form (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conclusion</span><p id="par0320" class="elsevierStylePara elsevierViewall">rAAA is a medical emergency with high morbidity and mortality rates and is a challenge for the general radiologist. The radiologist's commitment to rigorously analysing the morphology and characteristics of the aneurysm is essential for preparing an accurate report, and a vital part of the decision-making process to determine the best procedure to offer our patients.</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Authorship</span><p id="par0385" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0030"><li class="elsevierStyleListItem" id="lsti0120"><span class="elsevierStyleLabel">1.</span><p id="par0325" class="elsevierStylePara elsevierViewall">Responsible for the integrity of the manuscript: SLL, PCÁ and PSV.</p></li><li class="elsevierStyleListItem" id="lsti0125"><span class="elsevierStyleLabel">2.</span><p id="par0330" class="elsevierStylePara elsevierViewall">Conception of the manuscript: SLL.</p></li><li class="elsevierStyleListItem" id="lsti0130"><span class="elsevierStyleLabel">3.</span><p id="par0335" class="elsevierStylePara elsevierViewall">Design of the manuscript: SLL, PCÁ and PSV.</p></li><li class="elsevierStyleListItem" id="lsti0135"><span class="elsevierStyleLabel">4.</span><p id="par0340" class="elsevierStylePara elsevierViewall">Data collection: not applicable.</p></li><li class="elsevierStyleListItem" id="lsti0140"><span class="elsevierStyleLabel">5.</span><p id="par0345" class="elsevierStylePara elsevierViewall">Data analysis and interpretation: not applicable.</p></li><li class="elsevierStyleListItem" id="lsti0145"><span class="elsevierStyleLabel">6.</span><p id="par0350" class="elsevierStylePara elsevierViewall">Statistical processing: not applicable.</p></li><li class="elsevierStyleListItem" id="lsti0150"><span class="elsevierStyleLabel">7.</span><p id="par0355" class="elsevierStylePara elsevierViewall">Literature search: SLL, PCÁ and PSV.</p></li><li class="elsevierStyleListItem" id="lsti0155"><span class="elsevierStyleLabel">8.</span><p id="par0360" class="elsevierStylePara elsevierViewall">Drafting of the article: SLL, PCÁ and PSV.</p></li><li class="elsevierStyleListItem" id="lsti0160"><span class="elsevierStyleLabel">9.</span><p id="par0365" class="elsevierStylePara elsevierViewall">Critical review of the manuscript with intellectually relevant contributions: SLL, PCÁ and PSV.</p></li><li class="elsevierStyleListItem" id="lsti0165"><span class="elsevierStyleLabel">10.</span><p id="par0370" class="elsevierStylePara elsevierViewall">Approval of the final version: SLL, PCÁ and PSV.</p></li></ul></p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflicts of interest</span><p id="par0375" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:14 [ 0 => array:3 [ "identificador" => "xres1877410" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1628503" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1877411" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1628502" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Open surgery or EVAR" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Types of EVAR" ] 7 => array:3 [ "identificador" => "sec0020" "titulo" => "Radiology report" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0025" "titulo" => "Location" ] 1 => array:2 [ "identificador" => "sec0030" "titulo" => "Sac" ] 2 => array:2 [ "identificador" => "sec0035" "titulo" => "Aortic conus" ] 3 => array:2 [ "identificador" => "sec0040" "titulo" => "Arterial access" ] 4 => array:2 [ "identificador" => "sec0045" "titulo" => "Other considerations" ] ] ] 8 => array:2 [ "identificador" => "sec0050" "titulo" => "Measurements" ] 9 => array:2 [ "identificador" => "sec0055" "titulo" => "Proposal for structured report" ] 10 => array:2 [ "identificador" => "sec0060" "titulo" => "Conclusion" ] 11 => array:2 [ "identificador" => "sec0065" "titulo" => "Authorship" ] 12 => array:2 [ "identificador" => "sec0070" "titulo" => "Conflicts of interest" ] 13 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2022-07-15" "fechaAceptado" => "2022-11-04" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1628503" "palabras" => array:3 [ 0 => "Aortic aneurysms" 1 => "Endovascular procedures" 2 => "Aortic rupture" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1628502" "palabras" => array:3 [ 0 => "Aneurisma aorta abdominal" 1 => "Procedimiento endovascular" 2 => "Rotura aórtica abdominal" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Abdominal aortic aneurysm is defined as a dilatation of the abdominal aorta greater than 3<span class="elsevierStyleHsp" style=""></span>cm. Its prevalence is between 1 and 1.5 cases per 100 people, constituting an important cause of morbidity and mortality. Rare in women, its frequency increases with age and its most frequent location is between the renal arteries and the aorto-iliac bifurcation. Approximately 5% of cases will involve the visceral branches.</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">It is a silent pathological process whose natural evolution is rupture, which often has a fatal outcome and whose diagnosis is part of the pathology that we will find in emergency radiology. The involvement of the radiologist and the preparation of an accurate diagnostic report, as soon as possible, is essential for decision-making by the team in charge of the patient's surgery.</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Definimos el aneurisma de aorta abdominal como la dilatación de la aorta abdominal mayor de 3<span class="elsevierStyleHsp" style=""></span>cm. Su prevalencia se sitúa entre 1 y 1,5 casos por cada 100 personas, constituyendo una importante causa de morbimortalidad. Rara en mujeres, su frecuencia aumenta con la edad y su localización más frecuente es la alojada entre las arterias renales y la bifurcación aorto-ilíaca. Aproximadamente un 5% de los casos va a comprometer las ramas viscerales.</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Se trata de un proceso patológico silencioso cuya evolución natural es la rotura, que muchas veces tiene un desenlace fatal y cuyo diagnóstico forma parte de la enfermedad que nos encontraremos en la radiología de Urgencias. La implicación del radiólogo y la elaboración de un informe diagnóstico preciso, lo antes posible, es fundamental para la toma de decisiones por parte del equipo que se encargue de la cirugía del paciente.</p></span>" ] ] "multimedia" => array:7 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1342 "Ancho" => 2917 "Tamanyo" => 355316 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Types of graft.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 3310 "Ancho" => 2175 "Tamanyo" => 383087 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Location of abdominal aortic aneurysms.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 4005 "Ancho" => 2917 "Tamanyo" => 1480517 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Ruptured abdominal aortic aneurysm with measurements in orthogonal planes of the infrarenal neck (upper image) and aneurysmal sac (central image). Ruptured abdominal aortic aneurysm with measurements in orthogonal planes and diameter of the sac prior to iliac bifurcation. The images are distributed in sagittal (A), coronal (B) and axial (C) planes.</p>" ] ] 3 => array:8 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1803 "Ancho" => 2925 "Tamanyo" => 451875 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Measurements necessary for EVAR planning.</p>" ] ] 4 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">HU: Hounsfield units.</p>" "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Signs of high risk of rupture/imminent rupture of the AAA \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Signs of AAA rupture \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Chronic contained rupture \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Accelerated growth of the sac: 6−12<span class="elsevierStyleHsp" style=""></span>mm/year \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Retroperitoneal haematoma (40−70 HU) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Draped aorta sign<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>: associated with chronic contained rupture, which should meet the following conditions: \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– Known abdominal aortic aneurysm \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– Previous acute symptoms resolved \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– Haemodynamically stable patient with normal haematocrit \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– Computed tomography showing retroperitoneal haemorrhage or draped aorta with an organised thrombus \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Saccular or very eccentric morphology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Haematoma at the root of the mesentery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Absence of thrombus or thinning of the aneurysmal sac wall \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Blood collection in the psoas muscle without a cleavage plane with the aneurysmal sac \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ulceration of the aortic wall or <span class="elsevierStyleItalic">de novo</span> ulceration of the mural thrombus. Fragmentation of existing mural thrombus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Active extravasation of contrast outside the aneurysmal sac \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">High-attenuation crescent<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Draped aorta sign<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Discontinuity of parietal calcium lodged in the intima layer of the artery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mycotic/inflammatory aneurysms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">High-attenuation crescent sign: image of a well-defined, hyperdense crescent at the periphery of the thrombus. Represents bleeding inside the mural thrombus or the wall of the aneurysm. The earliest and most specific sign of ruptures.</p>" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">“Draped aorta” sign in which the posterior thin wall of the aorta is not identified. The aneurysm follows the contour of the vertebra on one or both sides and may be associated with vertebral erosion.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Radiological signs in an abdominal aortic aneurysm.</p>" ] ] 5 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0030" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PATIENT'S NAME: \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleBold">Med. Record No.</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleBold">DATE:</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleBold">DIAGNOSIS:</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Known ruptured/contained abdominal aortic aneurysm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleBold">LOCATION:</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="21" align="left" valign="middle"><elsevierMultimedia ident="202304071830582791"></elsevierMultimedia></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>- Infrarenal: \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>- Lowest renal artery: right/left \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>- Distance from the lowest renal artery: () mm \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>- Juxtarenal: \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>- Length of the neck: () mm \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>- Para/suprarenal: \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>- Arteries involved: \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>- Visceral stenosis: yes/no \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleBold">NECK:</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>- Length: () mm \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>- Condition of the neck: \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>- Hostile neck: yes/no \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>- Thrombus/Calcium: yes/no \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>- Angle: > or <60 degrees \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleBold">SAC MORPHOLOGY</span>: \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>- Fusiform/Saccular \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>- Mural thrombus: yes/no \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Circumferential: yes/no \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Eccentric: yes/no \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>- Aortic lumen diameter: () mm \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>- Angulation to the aortic axis: () mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>- Length: () mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Includes iliacs: yes/no \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>- Renal polar arteries involved: yes/no \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleBold">ARTERIAL ACCESS:</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>- Diameter of external iliac arteries and common femoral arteries: () mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Calcium: yes/no \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Tortuosity: yes/no \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleBold">OTHER SIGNIFICANT FINDINGS:</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>- Anatomical variants: yes/no. Location \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>- Visceral aneurysms: yes/no. Location \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>- Hypertrophic lumbar arteries: yes/no \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>- Concomitant processes (cancer patient, concurrent abdominal disorders): yes/no \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>- Previous abdominal surgery: yes/no \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>- Suspected mycotic abdominal aortic aneurysm: yes/no \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>- Lumen of the inferior mesenteric artery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleBold">COMMENTS:</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Proposal for structured report.</p>" ] ] 6 => array:5 [ "identificador" => "202304071830582791" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 1638 "Ancho" => 1250 "Tamanyo" => 125316 ] ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:23 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Abdominal aortic aneurysm in woman: prevalence. Risk factor and implications for screening" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.G. Derubertis" 1 => "S.M. Trocciola" 2 => "J.R. Ryer" 3 => "F.M. Pieracci" 4 => "J.F. McKinsey" 5 => "P.L. Faries" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jvs.2007.06.024" "Revista" => array:6 [ "tituloSerie" => "J Vasc Surg" "fecha" => "2007" "volumen" => "46" "paginaInicial" => "630" "paginaFinal" => "635" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17903646" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk factors for abdominal aortic aneurysms. A 7-year prospective study: Tthe Tromson Study, 1994–2001" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S.H. Forsdahl" 1 => "K. Singh" 2 => "S. Solberg" 3 => "B.K. Jacobsen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Circ" "fecha" => "2009" "volumen" => "119" "paginaInicial" => "2202" "paginaFinal" => "2208" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Abdominal aorta screening during transtoracic echocardiography" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "F. Roshanali" 1 => "M.H. Mandegar" 2 => "M.A. Yousefnia" 3 => "A. Mohammadi" 4 => "B. Baharvand" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1540-8175.2007.00467.x" "Revista" => array:6 [ "tituloSerie" => "Echocardiography" "fecha" => "2007" "volumen" => "24" "paginaInicial" => "685" "paginaFinal" => "688" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17651096" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalencia de aneurismas de aorta abdominal en una población de riesgo en una consulta de cirugía vascular" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E. Blanco" 1 => "P. Morata" 2 => "M. Muela" 3 => "B. García" 4 => "M. Guerra" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Angiología" "fecha" => "2020" "volumen" => "72" "paginaInicial" => "118" "paginaFinal" => "125" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aneurysmal vascular disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C.K. Zarins" 1 => "B.B. Hill" 2 => "Y.G. Wolf" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:6 [ "editores" => "C.M.TownsendJr, D.R.Beauchamp, M.B.Evers, K.L.Mattox, D.C.Sabiston" "titulo" => "Sabiston textbook of surgery" "paginaInicial" => "1357" "paginaFinal" => "1372" "edicion" => "16th ed." "serieFecha" => "2001" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recomendaciones de la guía para el diagnóstico y tratamiento del aneurisma de aorta abdominal" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Lahoz" 1 => "C.E. Gracia" 2 => "L. Reinares" 3 => "S. Bellmunt" 4 => "A. Brea" 5 => "A. 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