Overview of Acute Aortic Syndrome

Yıl 2024, Cilt: 33 Sayı: 1, 1 - 15, 31.03.2024

Onur Benli

https://doi.org/10.17827/aktd.1246236

Öz

Acute aortic syndrome; includes aortic dissection, intramural hematoma, symptomatic penetrating aortic ulcer. However, these three pathologies form a broad terminology group, including thoracic aortic aneurysm and traumatic aortic rupture, depending on their progression. Aortic dissection is the most common type. Type A aortic dissection requires emergency surgery, while Type B requires endovascular therapy. Intramural hematoma was defined as aortic wall hematoma without intimal flap. The ruptured aorta may progress to aortic dissection, aneurysm or pseudoaneurysm, or it may show complete resolution. It can be divided into proximal (type A) and distal (type B) Acute Aortic Syndrome according to the aortic segment involved surgically and prognostically. Surgical treatment can be recommended in most cases of type A intramural hematomas. In intramural hematomas localized in the descending
aorta, there was generally no difference in survival with surgical and medical treatment. Penetrating aortic ulcer; It describes ulceration of an atherosclerotic lesion that progresses to the media layer by perforating the internal elastic lamina. These patients may not progress clinically. Traumatic aortic rupture or transection are also aortic lesions that require early intervention. Treatment methods, surgical or endovascular interventions can be adjusted according to the clinical conditions of the patients.

Anahtar Kelimeler

Acute aortic syndrome, ıntramural hematoma, aortic dissection, traumatic aortic rupture, aneurysm

Akut Aortik Sendroma Genel Bakış

Öz

Akut aortik sendrom ; aort diseksiyonu , intramural hematom , semptomatik penetre aortik ülseri içine alan bir kavramdır. Ancak bu üç patoloji ilerleyişine göre torakal aort anevrizması ve travmatik aort rüptürünü de içine alarak geniş bir terminoloji grubunu oluşturur. Aort diseksiyonu en sık görülen tipidir. Tip A aort diseksiyonunda acil cerrahi gerekir iken, Tip B de endovascular tedavi gerekir. İntramural hematom, intimal flep olmadan aort duvarı hematomu olarak tanımlanmıştır. Rüptüre aorta , aort diseksiyonuna, anevrizma veya psödoanevrizmaya ilerleyebildiği gibi tam rezolüsyon da gösterebilir. Cerrahi ve prognostik olarak tutulan aort segmentine göre proksimal ( A tipi ) ve distal ( B tipi ) Akut Aortik Sendrom olarak ayrılabilir. A tipi İntramural hematomlarda çoğu olguda cerrahi tedavi önerilebilir. Desendan aortta lokalize İntramural hematomlarda cerrahi ve medikal tedavi ile yaşam süresinde genellikle fark bulunmamıştır. Penetran aortik ülser ise; internal elastik laminayı delerek media tabakasına ilerleyen aterosklerotik lezyonun ülserasyonunu tanımlar. Bu hastalarda klinik ilerleme olmayabilir. Travmatik aort rüptürü veya transeksiyon yine erken girişim gerektiren aort lezyonlarıdır. Tedavi yöntemleri, cerrahi ya da endovasküler girişimler hastaların klinik durumlarına göre ayarlanabilir.

Anahtar Kelimeler

Akut Aortik Sendrom, İntramural Hematom, Aort Diseksiyonu, Travmatik Aort Rüptürü, Anevrizma

Kaynakça

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