Acute aortic syndromes and aortic emergencies

Abstract

Acute aortic syndrome (AAS) and emergencies are relatively uncommon but are considered as life threatening, potentially fatal conditions. Different forms of aortic emergencies/AAS are often clinically indiscernible. Prompt and accurate diagnosis of these entities significantly influences prognosis and guides therapy. We aim to elucidate the pertinent role that radiology plays in the management of acute aortic diseases, with contrast-enhanced computed tomography angiography (CTA) being the most rapid and robust imaging technique.

Spontaneous Ruptured Aortic Plaques and Injuries Detected using Non-obstructive General Angioscopy

“…Aortic injuries in patients with acute and chronic aortic dissection have been reported 21,23) . The underlying etiology of acute aortic dissection is often an atherosclerotic disease 31) . Angioscopic findings include atherosclerotic changes 21,23) .…”

Acute Aorta Syndrome: A Case Study of Penetrating Aortic Ulcers in the Distal Abdominal Aorta

“…1 Even though other conditions represent aortic emergencies like trauma, iatrogenic, and ruptured atherosclerotic aneurysms that have similar signs and symptoms, the term AAS is typically reserved for the triad of AD, PAU, and IMH. 2 The underlying cause of AAS is most often due to significant atherosclerotic disease that is spread throughout the aorta; however, it can also result from other conditions such as medial degeneration, trauma, or infection. 2 The trio also share a common feature of a break, tear, or interruption of the media layer of the aortic wall as seen in Figure 14.…”

“…2 The underlying cause of AAS is most often due to significant atherosclerotic disease that is spread throughout the aorta; however, it can also result from other conditions such as medial degeneration, trauma, or infection. 2 The trio also share a common feature of a break, tear, or interruption of the media layer of the aortic wall as seen in Figure 14. The "break" will lead to a weakened wall segment that will swiftly increase the likelihood of aortic rupture.…”

“…An intimal flap will separate the true lumen (TL), which is continuous with the nondissected aortic segment, from the false lumen (FL). 2 AD is the most commonly associated and recognized pathological state in the triad of AAS. Aortic dissections are most frequently found in the ascending aorta but can also be seen throughout its entirety.…”

“…With the distal aorta being better visualized, the circumferential stenotic area was calculated at 78.8% ( Figure 6), which correlated with the velocities seen within this area. An anechoic area was now identified and measured at 1.04 cm 2 within the IMH as shown Figure 7. Power Doppler was the best modality to illustrate flow moving from the aorta through the break in the intima and into the ulcerated area.…”