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2016 ; 89
(1061
): 20150825
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MDCT evaluation of acute aortic syndrome (AAS)
#MMPMID27033344
Valente T
; Rossi G
; Lassandro F
; Rea G
; Marino M
; Muto M
; Molino A
; Scaglione M
Br J Radiol
2016[]; 89
(1061
): 20150825
PMID27033344
show ga
Non-traumatic acute thoracic aortic syndromes (AAS) describe a spectrum of
life-threatening aortic pathologies with significant implications on diagnosis,
therapy and management. There is a common pathway for the various manifestations
of AAS that eventually leads to a breakdown of the aortic intima and media.
Improvements in biology and health policy and diffusion of technology into the
community resulted in an associated decrease in mortality and morbidity related
to aortic therapeutic interventions. Hybrid procedures, branched and fenestrated
endografts, and percutaneous aortic valves have emerged as potent and viable
alternatives to traditional surgeries. In this context, current state-of-the art
multidetector CT (MDCT) is actually the gold standard in the emergency setting
because of its intrinsic diagnostic value. Management of acute aortic disease has
changed with the increasing realization that endovascular therapies may offer
distinct advantages in these situations. This article provides a summary of AAS,
focusing especially on the MDCT technique, typical and atypical findings and
common pitfalls of AAS, as well as recent concepts regarding the subtypes of AAS,
consisting of aortic dissection, intramural haematoma, penetrating
atherosclerotic ulcer and unstable aortic aneurysm or contained aortic rupture.
MDCT findings will be related to pathophysiology, timing and management options
to achieve a definite and timely diagnostic and therapeutic definition. In the
present article, we review the aetiology, pathophysiology, clinical presentation,
outcomes and therapeutic approaches to acute aortic syndromes.
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