Charlotte Sandström: Outcome of various treatments for aortic disease
A widening of the aorta, the body’s largest artery, can lead to a rupture that is acutely life-threatening. In Charlotte Sandström’s doctoral thesis, she investigates the outcomes of different methods to treat aortic disease. The research has yielded new insights that may reduce the risk of rupture and death.
CHARLOTTE SANDSTRÖM
Dissertation defense: 3 May 2024 (click for details)
Doctoral thesis: Endovascular repair of aortic disease. Clinical and radiological outcomes
Research area: Radiology and Imaging
Sahlgrenska Academy, The Institute of Clinical Sciences
The body’s largest artery, the aorta, can dilate into an aneurysm. With increasing width, the aneurysm carries an escalating risk of rupture – aortic rupture.
A contributing factor may be aortic dissection. This means that the thin innermost layer (intima layer) of the vessel wall has got a tear and a parallel lumen for the blood flow has been formed.
Aortic aneurysms can be treated with open surgery or with minimally invasive methods through the vessels, endovascularly. Endovascular treatment shows promising short-term results. However, it remains unclear how well the patient is protected from continued dilation and why aortic rupture still may occur after such treatment.
Developed a review protocol
What is your research about?
“We have investigated the long-term results both clinically and radiologically after two different treatment methods. Firstly, a new method of minimally invasive endovascular treatment of aortic dissection where the hole in the vessel wall’s intima layer is sealed with a plug. Secondly, the established endovascular treatment EVAR where a stent graft, a type of vessel prosthesis, is inserted into the aorta,” explains Charlotte Sandström, and continues:
“We have also investigated the causes and imaging signs of why EVAR does not exclude the aneurysm sac properly. This has been analyzed with a review protocol for computed tomography images that we have developed.”
“May reduce the risk of rupture”
What are the key research findings?
“Growth of an aneurysm after aortic dissection can be prevented with minimally invasive plug insertion and might be an alternative in cases where surgery is not possible. EVAR has poorer long-term survival than open surgery, and the findings of inadequate sealing in its attachment zones might be an explanation for this.”
What patient benefits can this research provide?
“More focus on detecting these findings of inadequate sealing and revised recommendations from stent graft manufacturers would likely reduce the risk of rupture and death,” says Charlotte Sandström.
“Research thinking in everyday work”
What has been enjoyable and rewarding about the doctoral project?
“Learning so much new and discovering how research thinking is needed in everyday work. It has been enjoyable and rewarding to work together with all co-authors, especially the closest project team, and learn from each other. We have supported each other when the work of data collection felt burdensome and shared the joy of discovering something important.”
Text: Jakob Lundberg