Aortic dissection is the most devastating complication of thoracic aortic disease. Pdf isolated spontaneous dissection of the abdominal aorta is such a rare entity and there are only a few cases reported in literature up to date. An aortic dissection happens when tears appear in the inner lining of the aorta, which is the main artery leaving the heart. Diseccion aortica, sindrome aortico agudo, aorta, aneurisma disecante. It is distinguished from the abdominal aortic or thoracic aortic aneurysm which is characterised by the chronic dilation of the aortic. This often catastrophic process commonly involves the thoracic aorta, and dissection limited to the abdominal aorta is rare. The mean sd expansion rate in the ascending aorta is 1. Blood surges into the tears, causing the aorta lining to split, or dissect. The management of localized abdominal aortic dissections. Aortic dissection and rupture is related to aortic diameter and expansion rate in many situations table 2. It is the tenth cause of death in caucasians in their 60s. In abdominal aortic aneurysm, antiplatelets seem to guard against aortic dissection and rupture. Aortic dissection ad occurs when an injury to the innermost layer of the aorta allows blood to flow between the layers of the aortic wall, forcing the layers apart. Aortic dissection an overview sciencedirect topics.
An aneurysm is a bulging, weak spot in the aorta that may be at risk for rupturing. Pdf spontaneous isolated dissection of the abdominal aorta. Acute dissection is the most common disease of the thoracic aorta and it is two or three times more frequent than the rupture of abdominal aortic aneurysm. The intimal tear may be a primary event or secondary to hemorrhage within the media. A national database analysis suggests that antiplatelet drugs may play a protective role in. Mri is more useful to assess aortic remod eling in patients with previous aortic. Review of the indications for, and the postoperative complications and mortality rates of endovascular techniques for treating abdominal aortic dissection aad. Most aneurysms are found during tests done for other reasons.
An aortic dissection is a rare, serious condition in which the inner layer of the aorta the biggest blood vessel in the body, coming directly from the heart tears. In this case, the aneurysm is in part of the aorta that is in the abdomen. Guidelines for diagnosis and treatment of aortic aneurysm. Acute aortic dissection is a multifactorial disease characterised by the separation of the aortic wall layers. A new appraisal of the management of acute aortic dissection is timely because of recent developments in diagnostic strategies including biomarkers and imaging, endograft design, and surgical treatment, which have led to a better understanding of the epidemiology, risk factors, and molecular nature of aortic dissection. Pmc images search for abdominal aortic dissection figure 1 ct of the abdomen and pelvis at the time of presentation. Aortic dissection is caused by an intimal and medial tear in the aorta with propagation of a false lumen within the aortic media. Aortic dissection is a more common problem than is ruptured abdominal aortic aneurysm. Acute aortic syndrome aas is a term that describes interrelated aortic. Aneurisma aortico abdominal sintomas y causas mayo clinic. The aorta is the main blood vessel that arises from the heart and supplies blood flow to the rest of the body. Spontaneous dissection of the abdominal aorta not associated with trauma or with descending thoracic aortic dissection is rare. New approaches to aortic diseases from valve to abdominal. There is 47 % prevalence and a mortality rate of 3060%.
The former type is called communicating aortic dissection, 4 and the latter noncommunicating aortic. Aortic dissection can occur in any parts of the aorta. Although the flap in aortic dissection usually has one to sev eral tears, some cases have no clear tear or no communication between the true lumen and the false lumen. Termina en una bifurcacion en las arterias iliacas comunes izquierda y derecha. It is part of the acute aortic syndrome an umbrella term for aortic dissection, intramural haematoma, and symptomatic aortic ulcer table. Abdominal aortic aneurysm aaa affects 45% of men over 65, and aortic dissection ad is a lifethreatening aortic pathology associated with high morbidity and mortality. A dissection of the aorta means that blood has entered the wall of the artery between the inner and middle layers. Aortic dissection causes, symptoms and treatment patient. In the more than 250 years since thoracic aortic dissection was. Isolated acute abdominal aortic dissection is a rare condition, accounting for 1. Aortic dimensions and the risk of dissection heart. Aorta definicion, funcion, anatomia, ramas, condiciones. Blood then surges through the tear, causing the inner and middle layers of the aorta to separate dissect.
Although aortic dissection has been found to occur in 1 of 363 autopsies, those limited to the abdominal aorta contribute only 2% to 4% of all cases. Two populationbased studies indicated incidences of 2. Aortic dissection is a catastrophic event with around 10,000 annual cases in the united states. Aortic syndromes, is the aortic dissection witches two or three times more often than the rupture of abdominal aortic aneurysm. Abdominal aortic aneurysm aaa repair is done to treat an aneurysm. Aortic dissections are classified according to the location of the initial aortic tear, and the parts of the aorta. An aortic dissection is an emergency with your aorta, which is the largest blood vessel in your body and the main artery that takes blood from your heart to the rest of your body during an. Isolated abdominal aortic dissection bmj case reports. The authors have found that very few patients who present with abdom ischemia survive. Aortic dissection is the surging of blood through a tear in the aortic intima with separation of the intima and media and creation of a false lumen channel.