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Pathophysiology, Classification and Principles of Management of Acute Aortic Syndromes

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Mechanisms of Vascular Disease

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Abstract

Acute aortic syndrome (Ciurica et al., Hypertension 73:951–960, 2019) comprises a group of potentially catastrophic aortic pathologies that need to be recognized and understood by modern vascular surgeons. The more modern nuances of approach to the diagnosis, classification and management of AAS are outlined, including various classification systems, and underlying pathological processes of the disease. A brief overview of medical management strategies for AAS is offered.

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Further Reading

  • Booher AM, Isselbacher EM, Nienaber CA, Trimarchi S, Evangelista A, Montgomery DG, et al. The IRAD classification system for characterizing survival after aortic dissection. Am J Med. 2013;126:730 e19–24.

    Google Scholar 

  • Dake MD, Thompson M, van Sambeek M, Vermassen F, Morales JP, Investigators D. DISSECT: a new mnemonic-based approach to the categorization of aortic dissection. Eur J Vasc Endovasc Surg. 2013;46:175–90.

    CAS  PubMed  Google Scholar 

  • Eggebrecht H, Plicht B, Kahlert P, Erbel R. Intramural hematoma and penetrating ulcers: indications to endovascular treatment. Eur J Vasc Endovasc Surg. 2009;38:659–65.

    CAS  PubMed  Google Scholar 

  • Erbel R, Aboyans V, Boileau C, Bossone E, Bartolomeo RD, Eggebrecht H, et al. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases. Eur Heart J. 2014;35:2873–926.

    PubMed  Google Scholar 

  • Fillinger MF, Greenberg RK, JF MK, Chaikof EL, Society for Vascular Surgery Ad Hoc Committee on TRS. Reporting standards for thoracic endovascular aortic repair (TEVAR). J Vasc Surg. 2010;52:1022–33, 33.e15.

    PubMed  Google Scholar 

  • Riambau V, Bockler D, Brunkwall J, Cao P, Chiesa R, Coppi G, et al. Editor’s choice—management of descending thoracic aorta diseases: clinical practice guidelines of the european society for vascular surgery (ESVS). Eur J Vasc Endovasc Surg. 2017;53:4–52.

    CAS  PubMed  Google Scholar 

  • Svensson LG, Labib SB, Eisenhauer AC, Butterly JR. Intimal tear without hematoma: an important variant of aortic dissection that can elude current imaging techniques. Circulation. 1999;99:1331–6.

    CAS  PubMed  Google Scholar 

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  1. Vascular Surgery, Royal Darwin Hospital, Darwin, NT, Australia

    Mark Hamilton

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  1. Discipline of Surgery, The University of Adelaide, Adelaide, SA, Australia

    Robert Fitridge

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Hamilton, M. (2020). Pathophysiology, Classification and Principles of Management of Acute Aortic Syndromes. In: Fitridge, R. (eds) Mechanisms of Vascular Disease. Springer, Cham. https://doi.org/10.1007/978-3-030-43683-4_14

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