Derleme
BibTex RIS Kaynak Göster

Overview of Acute Aortic Syndrome

Yıl 2024, , 1 - 15, 31.03.2024
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.

Kaynakça

  • 1. Vilacosta I,San Raman JA.Acute aortic syndrome.Heart 2001; 85:365-368.
  • 2. Vijay S. Ramanath, Jae K. Oh, Thoralf M. Sundt III, Kim A. Eagle. Acute Aortic Syndromes and Thoracic Aortic Aneurysm.Mayo Clin Proc. 2009;84(5):465-481.
  • 3. F. Ahmad,N Cheshire , M Hamady. Acute aortic syndrome: pathology and therapeutic strategies.Postgrad Med j2006;82:305-312.
  • 4. Larson EW,Edwars WD.Risk factorss for aortic dissection: a necropsy study of 161 cases.Am J Cardiol. 1984;53:849-855.
  • 5. Thomas t.Tsai,Christoph A.Nienaber , Kim A. Eagle. Acute Aortic Syndromes.Circulation 2005;112:3802-3813.
  • 6. Meszaros I,Morocz J,Szlavi J,Schmidt J,Tornoci L,Nagy L,Szep L. Epidemiology and clinicopathology of aortic dissection.Chest 2000; 117:1271-1278.
  • 7. RobertsCS,Roberts Wc. Aortic dissection with the entrance tear in the descending thoracic aorta: analysis of 40 necropsy patients.Ann Surg. 1991; 213: 356-368.
  • 8. Coady MA,Rizzo JA,Elefteriades JA. Pathologic variants of thoracic aortic dissections : Penetrating atherosclerotic ulsers and intramural haematomas.Cardiol Clin North Am 1999;113:603-604.
  • 9. Glower DD,Speier RH,White WD,Smith LR,Rankin JS,Wolfe WG.Management and long-term outcome of aortic dissection. Ann Surg 1991; 214:31-41.
  • 10. Nianaber CA,Sievers HH.Intramural hematoma in acute aortic syndrome:more than one variant of dissection?Circulation 2002;106:284-285.
  • 11. Evangelista A,Mukherjee D,Mehta RH et al.Acute intramural hematoma of aorta: a mystery in evolution.Circulation 2005;111:1063-1070.
  • 12. Macura JK, Corl FM,Fishman EK, et al.Pathogenesis in acute aortic syndromes: aortic dissection,intramural heamatoma and penetrating atherosclerotic aortic ulcer.A J R Am J Roentgenol 2003; 181:309-316
  • 13. Lissin LW,Vagelos R. Acute aortic syndrome: a case presentation and review of the literature.Vasc Med 2002;7:281-287.
  • 14. Nordon IM,Hinchliffe RJ,Loftus IM,Morgan RA,Thompson MM.Management of Acute aortic Syndrome and Chronic aortic dissection. Cardiovasc Intervent Radiol 2011;34:890-902.
  • 15. Ganaha F,Miller DC,Sugimoto K,Do YS,Minamiguchi H, Saito H, et al. Prognosis of aortic intramural hematoma with and without penetrating atherosclerotic ulcer : a clinical radiological analysis.Circulation.2002;106:342-8.
  • 16. Macura JK, Corl FM,Fishman EK, et al. Pathogenesis in acute aortic syndromes: aortic aneurysm leak and rupture and traumatic aortic aortic transection. A J R Am J Roentgenol 2003; 181:303-307.
  • 17. Azizzadeh A,Keyhani K,Miller CC 3rd ,Coogan SM,Safi HJ,Estrera AL. Blunt traumatic aortic injury: initial experience with endovascular repair. J Vasc Surg 2009;49:1403-1408.
  • 18. Nieaber CA, Fattori R,Mehta RH,Richartz MB,Evangalista A,Petzsch M,Cooper JV, Januzzi JL,Ince H,Sechtem U,Bossone E, Fang J, Smith DE, Isselbacher EM,Pape LA Eagle KA. Gender-related differences in acute aortic dissection. Circulation 2004;109:3014-3021.
  • 19. Hagan PG,Nieaber CA, Isselbacher EM , Bruckman D, Karavite DJ,Russman PL, Evangalista A Fattori R,Suzuki T, Oh JK,Moore AG, Malouf JF, Pape LA ,Gaca Sechtem U,Lenferik S,Deutsch HJ,Diedrichs H,Marcos Y, Robles J,Llovet A Gilon D, das SK, Armstrong WF, Deeb GM, Eagle KA. The International Registry of Acute Aortic Dissection(IRAD): new sights into an old disease.JAMA 2000; 283: 897-903.
  • 20. Kitai T,Kaji S, Yamamuro A,Tani T,Tamita K,Kinoshita M, et al. Clinical outcomes of medical therapy and timely operation in işnitially diagnosed type A aortic intramural hematoma:a 20 yearexperience. Circulation 2009; 120,11 Supp S 292-S298.
  • 21. Yapıcı F,Sokullu O.Akut aortik sendromlar: Pentran Aortik Ülser, Aort Transeksiyonu.Turkiye Klinikleri J Cardiovasc Surg-Special Topics 2012;4(1):47-57.
  • 22. Nienaber C, Powell J. Management of acute aortic syndromes. European Heart Journal 2012; 33:26-35.
  • 23. Richens D,Kotidis K,Neale M, Oakley C, Fails A.Rupture of the aorta following road traffic accidents in the United Kingdom 1992-1999.The results of the co-operative crash injury study. Eur J Cardiothorac Surg 2003;23: 143-148.
  • 24. Ince H.,Nieaber C.Management of Acute Aortic Syndromes.Rev Esp Cardiol 2007;60(5):526-41.
  • 25. Januzzi JL,Isselbacher EM,Fattori R, Cooper JV,Smith DE, Fang J, et al. Characterizing the young patient with aortic dissection: results from the International Registry of Aortic Dissection (IRAD). J Am Coll Cardiol 2004;43:665-9.
  • 26. Meszaros I,Morocz J, Szlavi J,Schmidt J,Tornoci L,Nagy L, et al. Epidemiology and clinicopathology of aortic dissection. Chest . 2000;117: 1271-8.
  • 27. Mehta RH,Suzuki T,Hagan PG,Bossone E,Gilon D,Llovet A,Maroto LC,Cooper JV,Smith DE, Armstrong WF, Nienaber CA, Eagle KA.Predicting death in patients with acute type a aortic dissection.Circulation 2002;105:200-206.
  • 28. Coselli JS,LeMaire SA.Thoracic aortic aneurysms and aortic dissection. In: Brunicardi FC(ed) Schwartz’s principles of surgery.McGraw-Hill,New York,pp 691-715.
  • 29. Taylor PR,Jacobs MJ.Thoracic and thoracoabdominal aortic aneurysms,dissections and acute aortic syndrome.In :Beard JD,Gaines PA(eds)Vascular and endovascular surgery.Elsevier, Amsterdam,pp 249-263.
  • 30. Von Kodolitsch Y,Csosz SK,Koschyk DH,Schalwat I, Loose R,Karck M et al.Intramural heamatoma of the aorta :predictors of progression to dissection and rupture. Circulation 2003;107:1158-1163.
  • 31. Maraj R,Rerkpattanapipat P,Jacobs JE et al. Meta-analysis of 143reported cases of aortic intramural hematoma.Am J Cardiol 86;2000:664-668.
  • 32. Nieanaber CA,von Kodolitsch Y,Peteren B,Loose R,Helmchen U,Haverich A et al.Intramural heamoarrhage of the thoracic aorta.Diagnostic and therapeutic implications.Circulation 1995;92:1465-72.
  • 33. Nianaber CA,Eagle KA.Aortic dissection : new frontiers in diagnosis and management, part I: from aetiology to diagnostişc strategies.Circulation 2003;108: 628-635.
  • 34. Swee W,Dake MD.Endovascular management of thoracic dissections.Circulation 2008:117:1460-1473.
  • 35. Nienaber CA,Rousseau H,Eggebrecht H et al. Randomized comparison of strategies for type aortic dissection:the INvestigation of STent grafts in Aortic Dissection(INSTEAD) trial.Circulation 2009;120:2519-2528
  • 36. Liu JC,Zhang JZ,Yang J ,Zuo J,Zhang JB,Yu SQ,Chen T,Xu XZ,Wei XF,Yi D.Combined interventionaland surgical treatment for acute aortic type a dissection.Cardiovasc Intervent Radiol 2008;31:745-50.
  • 37. Tsai TT,Nienaber CA, Eagle KA .Acute aortic syndromes.Circulation 2005;112: 3802-3813.
  • 38. Kan CB,Chang RY,Chang JP.Optimal initial treatment of type A intramural haematoma:clinical review.J Cardiothorac Surg 2008;33:1002-1006.
  • 39. Evangelista A,Eagle KA.Is the optimal management of acute type A aortic intramural haematoma evolving. Circulation 2009;120: 2029-2032.
  • 40. Jonker FHW,Verhagen HJM,Lin PH,Heijmen RH,Trimarchi S,Lee WA,Moll FL,Athamneh H,Muhs BE.Out comes of endovascular repair of ruptured descending thoracic aortic aneurysms.Circulation 2010; 121:2718-2723.
  • 41. Haverich A,Miller DC,Scott Wc,Mitchell Rs, Oyer Pe,Stinson Eb,Shumway Ne survivors. Acute and chronic aortic dissections: determinants of long-term outcome for operative survivors.Circulation;1994:90:2375- 2378.
  • 42. Sabik JF,Lyte BW,Blackstone EH,McCarthy PM,Loop FD,Cosgrove DM.Long-term effectiveness of operations for ascending aortic dissections.J Thorac Cardiovasc Surg. 2000;119:946-962.

Akut Aortik Sendroma Genel Bakış

Yıl 2024, , 1 - 15, 31.03.2024
https://doi.org/10.17827/aktd.1246236

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.

Kaynakça

  • 1. Vilacosta I,San Raman JA.Acute aortic syndrome.Heart 2001; 85:365-368.
  • 2. Vijay S. Ramanath, Jae K. Oh, Thoralf M. Sundt III, Kim A. Eagle. Acute Aortic Syndromes and Thoracic Aortic Aneurysm.Mayo Clin Proc. 2009;84(5):465-481.
  • 3. F. Ahmad,N Cheshire , M Hamady. Acute aortic syndrome: pathology and therapeutic strategies.Postgrad Med j2006;82:305-312.
  • 4. Larson EW,Edwars WD.Risk factorss for aortic dissection: a necropsy study of 161 cases.Am J Cardiol. 1984;53:849-855.
  • 5. Thomas t.Tsai,Christoph A.Nienaber , Kim A. Eagle. Acute Aortic Syndromes.Circulation 2005;112:3802-3813.
  • 6. Meszaros I,Morocz J,Szlavi J,Schmidt J,Tornoci L,Nagy L,Szep L. Epidemiology and clinicopathology of aortic dissection.Chest 2000; 117:1271-1278.
  • 7. RobertsCS,Roberts Wc. Aortic dissection with the entrance tear in the descending thoracic aorta: analysis of 40 necropsy patients.Ann Surg. 1991; 213: 356-368.
  • 8. Coady MA,Rizzo JA,Elefteriades JA. Pathologic variants of thoracic aortic dissections : Penetrating atherosclerotic ulsers and intramural haematomas.Cardiol Clin North Am 1999;113:603-604.
  • 9. Glower DD,Speier RH,White WD,Smith LR,Rankin JS,Wolfe WG.Management and long-term outcome of aortic dissection. Ann Surg 1991; 214:31-41.
  • 10. Nianaber CA,Sievers HH.Intramural hematoma in acute aortic syndrome:more than one variant of dissection?Circulation 2002;106:284-285.
  • 11. Evangelista A,Mukherjee D,Mehta RH et al.Acute intramural hematoma of aorta: a mystery in evolution.Circulation 2005;111:1063-1070.
  • 12. Macura JK, Corl FM,Fishman EK, et al.Pathogenesis in acute aortic syndromes: aortic dissection,intramural heamatoma and penetrating atherosclerotic aortic ulcer.A J R Am J Roentgenol 2003; 181:309-316
  • 13. Lissin LW,Vagelos R. Acute aortic syndrome: a case presentation and review of the literature.Vasc Med 2002;7:281-287.
  • 14. Nordon IM,Hinchliffe RJ,Loftus IM,Morgan RA,Thompson MM.Management of Acute aortic Syndrome and Chronic aortic dissection. Cardiovasc Intervent Radiol 2011;34:890-902.
  • 15. Ganaha F,Miller DC,Sugimoto K,Do YS,Minamiguchi H, Saito H, et al. Prognosis of aortic intramural hematoma with and without penetrating atherosclerotic ulcer : a clinical radiological analysis.Circulation.2002;106:342-8.
  • 16. Macura JK, Corl FM,Fishman EK, et al. Pathogenesis in acute aortic syndromes: aortic aneurysm leak and rupture and traumatic aortic aortic transection. A J R Am J Roentgenol 2003; 181:303-307.
  • 17. Azizzadeh A,Keyhani K,Miller CC 3rd ,Coogan SM,Safi HJ,Estrera AL. Blunt traumatic aortic injury: initial experience with endovascular repair. J Vasc Surg 2009;49:1403-1408.
  • 18. Nieaber CA, Fattori R,Mehta RH,Richartz MB,Evangalista A,Petzsch M,Cooper JV, Januzzi JL,Ince H,Sechtem U,Bossone E, Fang J, Smith DE, Isselbacher EM,Pape LA Eagle KA. Gender-related differences in acute aortic dissection. Circulation 2004;109:3014-3021.
  • 19. Hagan PG,Nieaber CA, Isselbacher EM , Bruckman D, Karavite DJ,Russman PL, Evangalista A Fattori R,Suzuki T, Oh JK,Moore AG, Malouf JF, Pape LA ,Gaca Sechtem U,Lenferik S,Deutsch HJ,Diedrichs H,Marcos Y, Robles J,Llovet A Gilon D, das SK, Armstrong WF, Deeb GM, Eagle KA. The International Registry of Acute Aortic Dissection(IRAD): new sights into an old disease.JAMA 2000; 283: 897-903.
  • 20. Kitai T,Kaji S, Yamamuro A,Tani T,Tamita K,Kinoshita M, et al. Clinical outcomes of medical therapy and timely operation in işnitially diagnosed type A aortic intramural hematoma:a 20 yearexperience. Circulation 2009; 120,11 Supp S 292-S298.
  • 21. Yapıcı F,Sokullu O.Akut aortik sendromlar: Pentran Aortik Ülser, Aort Transeksiyonu.Turkiye Klinikleri J Cardiovasc Surg-Special Topics 2012;4(1):47-57.
  • 22. Nienaber C, Powell J. Management of acute aortic syndromes. European Heart Journal 2012; 33:26-35.
  • 23. Richens D,Kotidis K,Neale M, Oakley C, Fails A.Rupture of the aorta following road traffic accidents in the United Kingdom 1992-1999.The results of the co-operative crash injury study. Eur J Cardiothorac Surg 2003;23: 143-148.
  • 24. Ince H.,Nieaber C.Management of Acute Aortic Syndromes.Rev Esp Cardiol 2007;60(5):526-41.
  • 25. Januzzi JL,Isselbacher EM,Fattori R, Cooper JV,Smith DE, Fang J, et al. Characterizing the young patient with aortic dissection: results from the International Registry of Aortic Dissection (IRAD). J Am Coll Cardiol 2004;43:665-9.
  • 26. Meszaros I,Morocz J, Szlavi J,Schmidt J,Tornoci L,Nagy L, et al. Epidemiology and clinicopathology of aortic dissection. Chest . 2000;117: 1271-8.
  • 27. Mehta RH,Suzuki T,Hagan PG,Bossone E,Gilon D,Llovet A,Maroto LC,Cooper JV,Smith DE, Armstrong WF, Nienaber CA, Eagle KA.Predicting death in patients with acute type a aortic dissection.Circulation 2002;105:200-206.
  • 28. Coselli JS,LeMaire SA.Thoracic aortic aneurysms and aortic dissection. In: Brunicardi FC(ed) Schwartz’s principles of surgery.McGraw-Hill,New York,pp 691-715.
  • 29. Taylor PR,Jacobs MJ.Thoracic and thoracoabdominal aortic aneurysms,dissections and acute aortic syndrome.In :Beard JD,Gaines PA(eds)Vascular and endovascular surgery.Elsevier, Amsterdam,pp 249-263.
  • 30. Von Kodolitsch Y,Csosz SK,Koschyk DH,Schalwat I, Loose R,Karck M et al.Intramural heamatoma of the aorta :predictors of progression to dissection and rupture. Circulation 2003;107:1158-1163.
  • 31. Maraj R,Rerkpattanapipat P,Jacobs JE et al. Meta-analysis of 143reported cases of aortic intramural hematoma.Am J Cardiol 86;2000:664-668.
  • 32. Nieanaber CA,von Kodolitsch Y,Peteren B,Loose R,Helmchen U,Haverich A et al.Intramural heamoarrhage of the thoracic aorta.Diagnostic and therapeutic implications.Circulation 1995;92:1465-72.
  • 33. Nianaber CA,Eagle KA.Aortic dissection : new frontiers in diagnosis and management, part I: from aetiology to diagnostişc strategies.Circulation 2003;108: 628-635.
  • 34. Swee W,Dake MD.Endovascular management of thoracic dissections.Circulation 2008:117:1460-1473.
  • 35. Nienaber CA,Rousseau H,Eggebrecht H et al. Randomized comparison of strategies for type aortic dissection:the INvestigation of STent grafts in Aortic Dissection(INSTEAD) trial.Circulation 2009;120:2519-2528
  • 36. Liu JC,Zhang JZ,Yang J ,Zuo J,Zhang JB,Yu SQ,Chen T,Xu XZ,Wei XF,Yi D.Combined interventionaland surgical treatment for acute aortic type a dissection.Cardiovasc Intervent Radiol 2008;31:745-50.
  • 37. Tsai TT,Nienaber CA, Eagle KA .Acute aortic syndromes.Circulation 2005;112: 3802-3813.
  • 38. Kan CB,Chang RY,Chang JP.Optimal initial treatment of type A intramural haematoma:clinical review.J Cardiothorac Surg 2008;33:1002-1006.
  • 39. Evangelista A,Eagle KA.Is the optimal management of acute type A aortic intramural haematoma evolving. Circulation 2009;120: 2029-2032.
  • 40. Jonker FHW,Verhagen HJM,Lin PH,Heijmen RH,Trimarchi S,Lee WA,Moll FL,Athamneh H,Muhs BE.Out comes of endovascular repair of ruptured descending thoracic aortic aneurysms.Circulation 2010; 121:2718-2723.
  • 41. Haverich A,Miller DC,Scott Wc,Mitchell Rs, Oyer Pe,Stinson Eb,Shumway Ne survivors. Acute and chronic aortic dissections: determinants of long-term outcome for operative survivors.Circulation;1994:90:2375- 2378.
  • 42. Sabik JF,Lyte BW,Blackstone EH,McCarthy PM,Loop FD,Cosgrove DM.Long-term effectiveness of operations for ascending aortic dissections.J Thorac Cardiovasc Surg. 2000;119:946-962.
Toplam 42 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Derleme
Yazarlar

Onur Benli 0000-0003-3623-6130

Yayımlanma Tarihi 31 Mart 2024
Kabul Tarihi 12 Ocak 2024
Yayımlandığı Sayı Yıl 2024

Kaynak Göster

AMA Benli O. Akut Aortik Sendroma Genel Bakış. aktd. Mart 2024;33(1):1-15. doi:10.17827/aktd.1246236