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Cardiovasc Intervent Radiol. 2011 Oct;34(5):890-902. doi: 10.1007/s00270-010-0028-3. Epub 2010 Nov 12.

Management of acute aortic syndrome and chronic aortic dissection.

Author information

1
St. George's Vascular Institute, St. James' Wing, St George's Hospital, Blackshaw Road, London SW17 0QT, UK. inordon@sgul.ac.uk

Erratum in

  • Cardiovasc Intervent Radiol. 2012 Apr;35(2):443.

Abstract

Acute aortic syndrome (AAS) describes several life-threatening aortic pathologies. These include intramural hematoma, penetrating aortic ulcer, and acute aortic dissection (AAD). Advances in both imaging and endovascular treatment have led to an increase in diagnosis and improved management of these often catastrophic pathologies. Patients, who were previously consigned to medical management or high-risk open surgical repair, can now be offered minimally invasive solutions with reduced morbidity and mortality. Information from the International Registry of Acute Aortic Dissection (IRAD) database demonstrates how in selected patients with complicated AAD the 30-day mortality from open surgery is 17% and endovascular stenting is 6%. Despite these improvements in perioperative deaths, the risks of stroke and paraplegia remain with endovascular treatment (combined outcome risk 4%). The pathophysiology of each aspect of AAS is described. The best imaging techniques and the evolving role of endovascular techniques in the definitive management of AAS are discussed incorporating strategies to reduce perioperative morbidity.

PMID:
21072634
DOI:
10.1007/s00270-010-0028-3
[Indexed for MEDLINE]

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