Key result
A review of pathophysiological mechanisms and treatment paradigms for acute aortic dissection highlights that lumen characteristics and branch vessel involvement can guide endovascular or surgical treatment.
Anatomical characteristics such as true and false lumen features, distal extent, and branch vessel involvement can serve as surrogate indications for endovascular or surgical treatment in acute aortic dissection.
May inform anatomy-based treatment selection in acute aortic dissection; leaves open prospective validation of lumen- and branch-vessel criteria.
The development of endovascular techniques has introduced a new dimension to the management of acute aortic dissection. Conventional therapy has traditionally been relegated to patients who experience severe clinical sequelae; unfortunately, clinicians have not been able to accurately predict the clinical consequences of a dissection. However, recent attention to true and false lumen characteristics, the distal extent of the dissection, and branch vessel involvement has demonstrated that these independent predictors of outcome can serve as surrogate indications for endovascular or surgical treatment. We review the pathophysiological mechanisms associated with the sequelae of aortic dissection and summarize the treatment paradigms we have developed.
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Greenberg et al. (2003) conducted a review in Acute aortic dissection. Endovascular or surgical treatment was evaluated. A review of pathophysiological mechanisms and treatment paradigms for acute aortic dissection highlights that lumen characteristics and branch vessel involvement can guide endovascular or surgical treatment.
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