Chronic aortic dissection: still a challenge.
Chronic aortic dissections are complex lesions with a fairly predictable natural history depending on factors such as baseline aortic diameter, the degree of false lumen thrombosis, the presence of a persistent communication, an underlying connective tissue disorder, and the control of hypertension. Medical management with antihypertensive therapy including beta-blockers is the treatment of choice for all stable chronic aortic dissections. Repair is indicated in the case of complications: aortic rupture, malperfusion syndromes, symptomatic dissections, asymptomatic dissections becoming significantly aneurysmal or demonstrating a rapid growth rate. In this regard, serial imaging of the aorta is crucial to detect unstable lesions requiring surgery or an endovascular intervention. As endograft technologies improve endovascular approach may become the future standard of care.
Giugliano
Giuseppe
G
Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University of Naples Federico II, Naples, Italy. a.giugliano@inwind.it
Spadera
Lucrezia
L
De Laurentis
Mario
M
Brevetti
Gregorio
G
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000784:Aortic Dissection / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D002908:Chronic Disease; D003952:Diagnostic Imaging / Q000379:methods; D006801:Humans; D006973:Hypertension / Q000150:complications; D011379:Prognosis; D014656:Vascular Surgical Procedures / Q000379:methods
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents