Division of Cardiology, University of Colorado, School of Medicine, Section of Vascular Medicine, Mail Stop B132, Leprino Building, 12401 East 17th Avenue, Room 560, Aurora, CO 80045, USA.
Division of Cardiovascular Surgery, University of Colorado, School of Medicine, 12631 East 17th Avenue, Room 6111, Aurora, CO 80045, USA.
Cardiol Clin. 2021 Nov;39(4):495-503. doi: 10.1016/j.ccl.2021.06.002.
Acute aortic syndromes, classified into aortic dissection, intramural hematoma, and penetrating aortic ulcer, are associated with high early mortality for which early diagnosis and management are crucial to optimize outcomes. Patients often present with nonspecific clinical symptoms and signs; therefore, it is important for providers to maintain a high index of suspicion for acute aortic syndromes. Electrocardiogram-gated computed tomographic angiography of the chest, abdomen, and pelvis is currently the most practical imaging modality for diagnosis and identification of complications. Evolution in surgical techniques and the development of aortic endografts have improved patient outcomes, but randomized trials are still needed.
急性主动脉综合征分为主动脉夹层、主动脉壁内血肿和穿透性主动脉溃疡,这些疾病的早期死亡率很高,因此早期诊断和治疗对于优化治疗效果至关重要。患者常出现非特异性的临床症状和体征;因此,临床医生对于急性主动脉综合征保持高度警惕是很重要的。心电图门控的胸部、腹部和盆腔计算机断层血管造影术是目前诊断和识别并发症的最实用的影像学方法。手术技术的进步和主动脉内支架的发展改善了患者的预后,但仍需要随机临床试验。