Chapter 44 - Acute Aortic Syndrome: Current Understandings

Abstract

The acute aortic syndrome consists of a spectrum of pathologies characterized by disruption in the integrity of the aortic wall, which may be associated with complications including ischemia, rupture, and death [1]. It comprises classical aortic dissection, intramural hematoma (IMH), penetrating aortic ulcer (PAU), acute aneurysm expansion, and traumatic aortic transection. Among these entities, aortic dissection is the commonest and entails significant morbidity and mortality if not appropriately treated. The emergence of advanced diagnostics and imaging along with advances in surgical technique and the rapidly expanding field of endovascular treatment mean we have a better understanding of the pathophysiology, natural history, and management of acute aortic syndrome, resulting in improved clinical outcomes. In this chapter, we review the epidemiology, pathophysiology, and clinical management of acute aortic syndrome, with particular emphasis on dissection, IMH, and PAU.