Diagnosis and Management of Acute Aortic Syndromes: Dissection, Penetrating Aortic Ulcer, and Intramural Hematoma

被引:46
作者
Sorber, Rebecca [1 ]
Hicks, Caitlin W. [1 ]
机构
[1] Johns Hopkins Univ, Div Vasc Surg & Endovasc Therapy, Johns Hopkins Med Inst, Dept Surg,Sch Med, 600 N Wolfe St,Halsted 668, Baltimore, MD 21287 USA
关键词
Aortic dissection; Intramural hematoma; Penetrating aortic ulcer; Acute aortic syndrome; TEVAR; Type B dissection; ATHEROSCLEROTIC ULCER; ENDOVASCULAR REPAIR; INTERNATIONAL REGISTRY; PRACTICE GUIDELINES; THORACIC SURGEONS; DESCENDING AORTA; NATURAL-HISTORY; B DISSECTION; STENT-GRAFTS; OUTCOMES;
D O I
10.1007/s11886-022-01642-3
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose of Review Acute aortic syndromes, including aortic dissection, intramural hematoma, and penetrating aortic ulcer, are a group of highly morbid, related pathologies that are defined by compromised aortic wall integrity. The purpose of this review is to summarize current management strategies for acute aortic syndromes. Recent Findings All acute aortic syndromes have potential for high morbidity and mortality and must be quickly identified and managed with the appropriate algorithm to prevent suboptimal outcomes. Recent trials suggest that TEVAR is increasingly useful in stabilizing pathology of the descending thoracic aorta but when possible should be applied in a delayed fashion and with limited coverage to minimize neurologic complications. Treatment for acute aortic syndrome is frequently dictated by the anatomic location and extent of the wall compromise as well as patient comorbidities. Therapy is often individualized and often includes some combination of medical, procedural, and surgical intervention.
引用
收藏
页码:209 / 216
页数:8
相关论文
共 56 条
[1]   Epidemiology of fatal ruptured aortic aneurysms in the United States (1999-2016) [J].
Abdulameer, Halah ;
Al Taii, Haider ;
Al-Kindi, Sadeer G. ;
Milner, Ross .
JOURNAL OF VASCULAR SURGERY, 2019, 69 (02) :378-+
[2]   Multimodality Imaging of Thoracic Aortic Diseases in Adults [J].
Bhave, Nicole M. ;
Nienaber, Christoph A. ;
Clough, Rachel E. ;
Eagle, Kim A. .
JACC-CARDIOVASCULAR IMAGING, 2018, 11 (06) :903-919
[3]   Diagnosis and Management of Acute Aortic Syndromes: Dissection, Intramural Hematoma, and Penetrating Aortic Ulcer [J].
Bonaca, Marc P. ;
O'Gara, Patrick T. .
CURRENT CARDIOLOGY REPORTS, 2014, 16 (10) :1-13
[4]   Endovascular Repair of Acute Uncomplicated Aortic Type B Dissection Promotes Aortic Remodelling: 1 Year Results of the ADSORB Trial [J].
Brunkwall, J. ;
Kasprzak, P. ;
Verhoeven, E. ;
Heijmen, R. ;
Taylor, P. ;
Alric, P. ;
Canaud, L. ;
Janotta, M. ;
Raithel, D. ;
Malina, M. ;
Resch, Ti ;
Eckstein, H. -H. ;
Ockert, S. ;
Larzon, T. ;
Carlsson, F. ;
Schumacher, H. ;
Classen, S. ;
Schaub, P. ;
Lammer, J. ;
Lonn, L. ;
Clough, R. E. ;
Rampoldi, V. ;
Trimarchi, S. ;
Fabiani, J. -N. ;
Boeckler, D. ;
Kotelis, D. ;
Boeckler, D. ;
Kotelis, D. ;
von Tenng-Kobligk, H. ;
Mangialardi, N. ;
Ronchey, S. ;
Dialetto, G. ;
Matoussevitch, V. .
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, 2014, 48 (03) :285-291
[5]   Multicenter clinical trial of the conformable stent graft for the treatment of acute, complicated type B dissection [J].
Cambria, Richard P. ;
Conrad, Mark F. ;
Matsumoto, Alan H. ;
Fillinger, Mark ;
Pochettino, Alberto ;
Carvalho, Stephanie ;
Patel, Virendra ;
Matsumura, Jon .
JOURNAL OF VASCULAR SURGERY, 2015, 62 (02) :271-278
[6]   Endovascular versus medical management of type B intramural hematoma: a meta-analysis [J].
Chakos, Adam ;
Twindyawardhani, Tisha ;
Evangelista, Arturo ;
Maldonado, Giuliana ;
Piffaretti, Gabriele ;
Yan, Tristan D. ;
Tian, David H. .
ANNALS OF CARDIOTHORACIC SURGERY, 2019, 8 (04) :447-+
[7]   Penetrating atherosclerotic ulcer of the descending thoracic aorta and arch [J].
Cho, KR ;
Stanson, AW ;
Potter, DD ;
Cherry, KJ ;
Schaff, HV ;
Sundt, TM .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2004, 127 (05) :1393-1401
[8]   Long-term behavior of aortic intramural hematomas and penetrating ulcers [J].
Chou, Alan S. ;
Ziganshin, Bulat A. ;
Charilaou, Paris ;
Tranquilli, Maryann ;
Rizzo, John A. ;
Elefteriades, John A. .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2016, 151 (02) :361-U175
[9]   Thoracic Endovascular Aortic Repair for Penetrating Aortic Ulcer: Literature Review [J].
D'Annoville, Thomas ;
Ozdemir, Baris Ata ;
Alric, Pierre ;
Marty-Ane, Charles Henri ;
Canaud, Ludovic .
ANNALS OF THORACIC SURGERY, 2016, 101 (06) :2272-2278
[10]  
Daily P O, 1970, Ann Thorac Surg, V10, P237