Management of patients with aortic dissection

Dtsch Arztebl Int. 2008 Sep;105(38):639-45. doi: 10.3238/arztebl.2008.0639. Epub 2008 Sep 19.

Abstract

Introduction: The incidence of acute diseases of the aorta will continue to rise as our population ages.

Methods: Selective literature review.

Results/discussion: At centers specializing in maximum care, it is important that a specific strategy should be established in cases of clinically suspected, acute aortic diseases, and non-invasive diagnostic measures should be taken without delay. If an acute aortic dissection is diagnosed, the necessary treatment must be provided immediately. As this disease is life-threatening, a cooperating network of referring physicians and institutions should be set up in order to ensure optimal treatment for these desperately ill patients. Acute type A aortic dissections generally require surgery, while the primary treatment of uncomplicated type B dissections is conservative and complicated type B dissections can be treated primarily with stent-graft implantation. The referring medical specialists and institutions should follow the patients closely after treatment so that any problems that may develop can be recognized and treated in timely fashion.

Keywords: aortic dissection; classification; diagnosis; endovascular treatment; surgical treatment.