Acute Aortic Dissection with Intramural Hematoma

1996 ◽  
Vol 11 (1) ◽  
pp. 46-52 ◽  
Author(s):  
Koichi Ide ◽  
Hideo Uchida ◽  
Hideaki Otsuji ◽  
Kiyoshi Nishimine ◽  
Juichi Tsushima ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Intramural Hematoma

scholarly journals Head and Neck Pain in Patients Presenting with Acute Aortic Dissection

Aorta ◽  
2018 ◽  
Vol 06 (06) ◽  
pp. 130-138 ◽  
Author(s):  
Stephen Philip ◽  
Emil Missov ◽  
Dan Gilon ◽  
Stuart Hutchison ◽  
Ali Khoynezhad ◽  
...  
Keyword(s):  
Back Pain ◽  
Aortic Dissection ◽  
Neck Pain ◽  
Head And Neck ◽  
Acute Aortic Dissection ◽  
Intramural Hematoma ◽  
Type A ◽  
White Female ◽  
Comorbidity Burden ◽  
Overall Mortality

Background Head and neck pain is an atypical presentation of acute aortic dissection. Classic teaching associates this pain with proximal dissections, but this has not been extensively studied. Methods Patients enrolled in the International Registry of Acute Aortic Dissection from January 1996 to March 2015 were included in this study. We analyzed the demographics, presentation, treatment, and outcomes of Type A aortic dissection patients presenting with head and neck pain (n = 812, 25.8%) and compared it with those without these symptoms (n = 2,341, 74.2%). Results Patients with head and neck pain were more likely to be white, female, with a family history of aortic disease. Patients with head and neck pain had higher percentages of back pain (43.3% vs. 37.5%, p = 0.005) and chest pain (87.6% vs. 79.3%, p < 0.001). On imaging, a higher percentage of those with head and neck pain had arch vessel involvement (44.3% vs. 38%, p = 0.010) and intramural hematoma (11.7% vs. 8.1%, p = 0.003). Surgical management was more common in patients with head and neck pain (89.8% vs. 85.2%, p = 0.001). Regarding outcomes, patients with head and neck pain had significantly higher rates of stroke than those without head and neck pain (13% vs. 9.9%, p = 0.016); however, overall mortality was lower for those with head and neck pain (19.5% vs. 23%, p = 0.038). Those with head and neck pain only had higher overall mortality compared to those with head and neck pain with chest or back pain (34.6% vs. 19.9%, p = 0.013). A logistic regression of mortality revealed that preoperative hypotension and age > 65 years were significantly associated with increased mortality. Conclusion Presence of head and neck pain in Type A dissection is associated with more arch involvement, intramural hematoma, and stroke. When isolating those with head and neck pain only, there appear to be a higher rate of comorbidity burden and higher overall mortality.

scholarly journals Optimal treatment strategy for type A acute aortic dissection with intramural hematoma

2014 ◽  
Vol 147 (1) ◽  
pp. 307-311 ◽  
Author(s):  
Mitsumasa Hata ◽  
Hiroaki Hata ◽  
Akira Sezai ◽  
Isamu Yoshitake ◽  
Shinji Wakui ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Treatment Strategy ◽  
Acute Aortic Dissection ◽  
Intramural Hematoma ◽  
Type A ◽  
Optimal Treatment ◽  
Optimal Treatment Strategy

scholarly journals Case Series: Pulmonary Artery Intramural Hematoma in Stanford Type A Acute Aortic Dissection

2021 ◽  
Vol 105 (1) ◽  
Author(s):  
Jeanne Gros-Gean ◽  
Olivier Lebecque ◽  
Alain Nchimi ◽  
Mihaela-Magdalena Vlad
Keyword(s):  
Aortic Dissection ◽  
Pulmonary Artery ◽  
Acute Aortic Dissection ◽  
Case Series ◽  
Intramural Hematoma ◽  
Type A

scholarly journals Surgical treatment of intramural hematoma of the ascending aorta

2016 ◽  
Vol 144 (3-4) ◽  
pp. 196-199
Author(s):  
Stamenko Susak ◽  
Aleksandar Redzek ◽  
Vladimir Torbica ◽  
Jovan Rajic ◽  
Mirko Todic
Keyword(s):  
Aortic Dissection ◽  
Open Surgery ◽  
Aortic Wall ◽  
Acute Aortic Dissection ◽  
Treatment Options ◽  
Intramural Hematoma ◽  
Ascending Aorta ◽  
Vasa Vasorum ◽  
Convex Side ◽  
Intimal Tear

Introduction. Intramural hematoma of the aorta presents potentially fatal condition developing as a result of a vasa vasorum rupture. It is a major risk factor for developing a frank aortic dissection. Case Outline. A 65-year-old woman was admitted to our clinic for the second time, after her symptoms of chest pain and vertigo (with no electrocardiographic signs of myocardial infarction) hadn?t disappeared after several months of medicament treatment (indicated in the first hospitalization). Computed tomography arteriography of the aorta showed no sign of acute aortic dissection, but revealed a contrast depo in the aortic wall of 8 ? 14 mm dimensions, with no extravasation of contrast. Also, massive pericardial effusion was observed (10-30 mm in thickness). Transesophageal echocardiography confirmed these findings completely. The patient underwent surgery, in which plaque exulceration was detected on the convex side of the ascending aorta, 3 cm above the aortic valve, 1 cm in diameter, with no signs of intimal tear. A resection of the ascending aorta was performed, and the aorta was reconstructed with a 30 mm Dacron tube graft. The patient was discharged on the 14th postoperative day with satisfactory results. Conclusion. Intramural hematoma is not a common event, but it is potentially a fatal one. Open surgery in patients with an intramural hematoma is an effective treatment strategy, although percutaneous endovascular treatment options are being described.

Aortic Dissection

2018 ◽  
Author(s):  
Kristine C Orion ◽  
James H Black III
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Intramural Hematoma ◽  
Current Treatment ◽  
Penetrating Aortic Ulcer ◽  
Uncommon Condition ◽  
Best Medical Therapy ◽  
Malperfusion Syndrome ◽  
Prompt Diagnosis ◽  
Stanford Type B

Acute aortic dissection remains a lethal but uncommon condition. Historically, Stanford type B dissections are managed with best medical therapy whereas Stanford type A dissections are surgically treated. In the last decade, worldwide evidence has been building that has questioned optimal treatment for the former. In this review, we discuss the general features of aortic dissection, the pathophysiology and risk factors, appropriate imaging to make a prompt diagnosis, and current treatment principles and methods. This review contains 82 references, 6 figures and 5 tables. Key words: aortic aneurysm, aortic dissection, intramural hematoma, malperfusion syndrome, penetrating aortic ulcer, thoracoabdominal

Sign in / Sign up

Export Citation Format

Share Document