Ruptured Aortic Aneurysm and Dissection Related Death: an Autopsy Database Analysis

Abstract

Acute aortic catastrophes (AAC), mainly ruptured aneurysms and dissections, lead all other vascular conditions in morbidity and mortality, even if intervention occurs. The aim of our study was to give a descriptive overview of the demographic and pathological characteristics of AAC. Between 1994 and 2013, 80,469 autopsies were performed at Semmelweis University hospitals in Budapest. After collecting the autopsy reports we were able to create the AAC database upon which we conducted our analysis. We found 567 cases of AAC. The cause of death in 120 of them was classified as a non-ruptured aorta with malperfusion or distal embolization. Of the remaining 447 cases, in 305 the cause of death was a ruptured aortic aneurysm (rAA), and in 142 it was a ruptured aortic dissection (rAD). The distribution of rAA cases was 34.4% thoracal, 4.3% thoracoabdominal, and 61.3% abdominal. We found female dominance where the rAA was thoracal. In rAD cases, 84% were Stanford A and 16% Stanford B type. In both groups we found different pathological distributions. In the prehospital group, the number of thoracal ruptures was considerable. 88% of the patients with Stanford A dissection died in the prehospital or perioperative period. The most progressive AACs were ruptures of intrapericardial aneurysms and Stanford A dissections., however survival rate can be elevated by using rapid imaging examination and immediate surgical intervention. We want to highlight that our study contains such gender differences, which are worth to be taken into consideration.

Clinical Features of 544 Patients With Ruptured Aortic Aneurysm ― A Report From the Tokyo Acute Aortic Super Network Database ―

“…A previous study had reported that among patients with ruptured TAA, prehospital death was highest for TAA-asc. 10 We could not find any significant differences in patient characteristic between the 5 groups of aortic aneurysms, and between the broadly defined TAA group (TAA and TAAA) and AAA group. A recent study reported that AAA was more strongly associated with atherosclerosis than TAA.…”

New Directions in Diagnostics for Aortic Aneurysms: Biomarkers and Machine Learning

“…Autopsy studies have revealed that the most common cause of death due to AA is rupture [6]. This highlights the critical need for developing a standardized screening technique for early diagnosis to mitigate life-threatening complications.…”

Interdisciplinary German clinical practice guidelines on the management of type B aortic dissection

“…An autopsy study revealed that 50% of type A dissections in emergency departments remain undetected [ 19 ]. In another autopsy study, which was carried out in Hungary where all sudden deaths undergo an autopsy, it was shown that only 6% of the patients with ruptured aortic dissection reached hospital [ 20 ].…”