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

  • Peripheral Vascular Disease (WS Jones, Section Editor)
  • Published:
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Abstract

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.

Summary

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.

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  1. Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, The Johns Hopkins Medical Institutions, Johns Hopkins University School of Medicine, 600 N Wolfe St, Halsted 668, Baltimore, MD, 21287-8611, USA

    Rebecca Sorber & Caitlin W. Hicks

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  1. Rebecca Sorber
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Correspondence to Caitlin W. Hicks.

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Conflict of Interest

Dr. Hicks reports grants from NIH/NIDDK, the Society for Vascular Surgery, and the American College of Surgeons, and others from Cook Medical Inc. and W.L. Gore & Associates, outside the submitted work. The authors declare that they have no conflicts of interest or relevant financial relationships to disclose. This work did not receive funding from any public or private institution or individual.

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Sorber, R., Hicks, C.W. Diagnosis and Management of Acute Aortic Syndromes: Dissection, Penetrating Aortic Ulcer, and Intramural Hematoma. Curr Cardiol Rep 24, 209–216 (2022). https://doi.org/10.1007/s11886-022-01642-3

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