Natural history of descending thoracic and thoracoabdominal aneurysms

Griepp, Randall B.; Ergin, Mehmet; Galla, Jan D.; Lansman, Steven L.; McCullough, Jock N.; Nguyen, Khanh; Klein, James J.; Spielvogel, David

doi:10.1016/s0003-4975(99)00427-0

Cited by 162 publications

(89 citation statements)

References 12 publications

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“…Neste sentido, alguns complicados modelos de equações exponenciais têm sido propostos para cálculo da estimativa de eventos agudos em casos de AAD 140,141 . O grupo da Yale University tem realizado estudos evolutivos consistentes e simplificados 77,133,142,143 , apontando o diâmetro como o mais relevante fator independente de risco para complicações.…”

Section: Aorta Descendente -Toraco-abdominalunclassified

Diretrizes para a cirurgia das doenças da aorta

Albuquerque¹,

Palma²,

Braile³

et al. 2004

Arq. Bras. Cardiol.

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Section: Aorta Descendente -Toraco-abdominalunclassified

Diretrizes para a cirurgia das doenças da aorta

Albuquerque¹,

Palma²,

Braile³

et al. 2004

Arq. Bras. Cardiol.

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“…32,33 A history of smoking is strongly associated with the development of thoracic and abdominal aortic aneurysms and is a strong predictor for aneurysmal rupture, likely secondary to the destructive effects of tobacco use on connective tissue. 34 Not surprisingly, a clear link between COPD and aneurysmal rupture also exists. 6 Johansson et al 35 showed a marked increase in the incidence of ruptured TAAs with aging, as patients in their sixties were compared with their octogenarian counterparts.…”

Section: Aortic Dissectionmentioning

confidence: 99%

“…This direct correlation between age and incidence is not sex specific; the increase is nearly identical between men and women. 34 Hypertension, in particular diastolic hypertension, is widely seen among patients with aortic aneurysm, and with it comes a greater risk for rupture. 34,36 Thus, aggressive management of high blood pressure in the outpatient setting is paramount, and the threshold for referral of these patients for surgical repair should be lower, especially in patients with more difficult-to-control hypertension.…”

Section: Aortic Dissectionmentioning

confidence: 99%

“…34 Hypertension, in particular diastolic hypertension, is widely seen among patients with aortic aneurysm, and with it comes a greater risk for rupture. 34,36 Thus, aggressive management of high blood pressure in the outpatient setting is paramount, and the threshold for referral of these patients for surgical repair should be lower, especially in patients with more difficult-to-control hypertension. Finally, other causes of TAA include syphilis and infectious aortitis, both of which are extremely rare in developed countries.…”

Section: Aortic Dissectionmentioning

confidence: 99%

“…Several studies have shown an increasing risk of rupture after the TAA has surpassed 5 cm in diameter. 34,47,48 In fact, one study showed that the risk of rupture nearly doubles with every 1-cm increment of aneurysmal diameter. 32 Subsequently, rapid rates of expansion were found to be an independent risk factor for TAA rupture.…”

Section: Thoracic Aortic Aneurysmsmentioning

confidence: 99%

See 2 more Smart Citations

Acute Aortic Syndromes and Thoracic Aortic Aneurysm

Ramanath

Sundt

et al. 2009

Mayo Clinic Proceedings

192

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Acute and chronic aortic diseases have been diagnosed and studied by physicians for centuries. Both the diagnosis and treatment of aortic diseases have been steadily improving over time, largely because of increased physician awareness and improvements in diagnostic modalities. This comprehensive review discusses the pathophysiology and risk factors, classification schemes, epidemiology, clinical presentations, diagnostic modalities, management options, and outcomes of various aortic conditions, including acute aortic dissection (and its variants intramural hematoma and penetrating aortic ulcers) and thoracic aortic aneurysms. Literature searches of the PubMed database were conducted using the following keywords: aortic dissection, intramural hematoma, aortic ulcer, and thoracic aortic aneurysm. Retrospective and prospective studies performed within the past 20 years were included in the review; however, most data are from the past 15 years. and studied by physicians for centuries. Descriptions of such pathologic conditions of the aorta as aneurysm and dissection date back as early as the 2nd century during the time of Galen, whose discoveries were largely made through studies of apes. More "recent" reports were described by Vesalius in 1557, followed by Nichols in 1732, who detailed the process of aortic dissection. In 1761, Morgagni reported detailed pathologic features of a patient with a ruptured aorta. 1 However, our true understanding of aortic pathology began with the dissertation by Shennan 2 in 1934, which included a description of penetrating atheromatous plaques of the thoracic aorta. His report was followed by the first successful management of aortic dissection by DeBakey in 1955. 1 Since then, our knowledge of the pathologic conditions of the aorta has grown considerably and continues to evolve with ongoing research into the pathophysiology of these conditions, technological advances in the modes of detection, and improved therapeutic options. Clinical databases, such as the International Registry of Acute Aortic Dissection (IRAD), the largest current registry for acute aortic syndromes, have also contributed tremendously to our knowledge of acute aortic pathology.For the practicing clinician, knowledge of aortic disease is paramount because patients with aortic conditions contribute significantly to the overall mortality from cardiovascular disease. This review discusses the pathophysiology, epidemiology, presentation, diagnosis, and therapeutic options for several forms of acute and chronic aortic pathology: aortic dissection (including its variants intramural hematoma [IMH] and penetrating atheromatous aortic ulcer) and thoracic aortic aneurysm (TAA). Literature searches were performed of the PubMed database using the following key words: aortic dissection, intramural hematoma, aortic ulcer, and thoracic aortic aneurysm. Retrospective and prospective studies conducted within the past 15 years, along with some data from years prior, were included in this review.

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