Abstract
ObjectivesTo demonstrate the various presentations of acute aortic pathology and to present diagnostic and therapeutic approaches.MethodsDiagnostic imaging is the key to the reliable diagnosis of acute aortic pathology with multi-slice computed tomography angiography (CTA) as the fastest and most robust modality. Endovascular aortic repair (EVAR) with stent grafts and open surgical repair are therapeutic approaches for aortic pathology.ResultsCTA is reliable in diagnosing and grading aortic trauma, measuring aortic diameter in aortic aneurysms and detecting vascular wall pathology in acute aortic syndrome and aortic inflammation. CTA enables planning the optimal therapeutic approach. Stent graft implantation and/or an open surgical approach can address vascular wall pathology and exclude aortic aneurysms.ConclusionAortic emergencies have to be detected quickly. CTA is the imaging method of choice and helps to decide whether elective, urgent or emergent treatment is necessary with EVAR and open surgical repair as the main treatment approaches.Teaching Points• To present aortic pathology caused by trauma • To present acute aortic syndrome (aortic dissection, intramural haematoma and penetrating ulcers) • To present symptomatic and ruptured aortic aneurysm • To present infection (mycotic aneurysms/aorto-duodenal fistulae) or iatrogenic injury of the aorta • To understand different presentations for treatment planning (EVAR and open surgery)
Highlights
Aortic emergencies present a diagnostic and treatment challenge for emergency physicians [1].Aortic emergencies comprise different clinical entities with only one thing in common: if not diagnosed and managed in due time they are life threatening [2,3,4,5]
computed tomography angiography (CTA) has become the best modality for the diagnosis and treatment planning of aortic pathologies [3, 4, 6, 7]
Since the predilection site for aortic injury is at the aortic isthmus in proximity to the left subclavian artery, stent graft implantation in up to 30 % of the cases will result in partial or complete coverage of the left subclavian artery [13]
Summary
Aortic emergencies present a diagnostic and treatment challenge for emergency physicians [1]. Aortic emergencies comprise different clinical entities with only one thing in common: if not diagnosed and managed in due time they are life threatening [2,3,4,5]. Compared to myocardial infarction and stroke, aortic pathologies are relatively rare (Table 1). A rapid diagnosis and treatment decision is necessary to decrease mortality. CTA has become the best modality for the diagnosis and treatment planning of aortic pathologies [3, 4, 6, 7]. Treatment is performed by either an open surgical approach or endovascular stent graft implantation (endovascular aortic repair,EVAR) [3, 7,8,9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
