D-dimer can be used to rule out aortic dissection

RAH registrar Jorinde Helmich recently presented this article:

Shimony2014-ddimer_aorticDissection

 

With the interesting conclusion:

 

Acute aortic dissection can be ruled out with a high certainty in patients with a plasma D-dimer level < 500 ng/ml

 

As long as we apply this only in patients with otherwise low risk, and other reassuring clinical findings (sounds very much like the use of d-dimer in exclusion of PE).

A contemporaneous review, however, concluded that:

There is inadequate evidence to support the use of D-dimer to exclude acute aortic dissection.

 

So, do we have an answer on this question? Is d-dimer useful at all in excluding aortic dissection?

See her presentation here, and read the full article below, and let us know your opinion...

 

Read the article

 

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