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Aortic Dissection
Leann Kania, MD; Andrej Lyshchik, MD, PhD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Abbreviations

          • Abdominal aortic dissection (AAD)
        • Definitions

          • Intimal tear of abdominal aorta (inferior to diaphragm) with blood/clot separating intima and media, creating 2 distinct lumina

        IMAGING

        • General Features

          • Ultrasonographic Findings

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Image Interpretation Pearls

                                  • Reporting Tips

                                    Selected References

                                    1. Nauta FJ et al: Update in the management of type B aortic dissection. Vasc Med. 21(3):251-63, 2016
                                    2. Guirguis-Blake JM et al: Ultrasonography screening for abdominal aortic aneurysms: a systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med. 160(5):321-9, 2014
                                    3. Roger VL et al: Heart disease and stroke statistics--2012 update: a report from the American Heart Association. Circulation. 125(1):e2-e220, 2012
                                    4. Criado FJ: Aortic dissection: a 250-year perspective. Tex Heart Inst J. 38(6):694-700, 2011
                                    5. McMahon MA et al: Multidetector CT of aortic dissection: A pictorial review. Radiographics. 30(2):445-60, 2010
                                    6. Jonker FH et al: Dissection of the abdominal aorta. Current evidence and implications for treatment strategies: a review and meta-analysis of 92 patients. J Endovasc Ther. 16(1):71-80, 2009
                                    7. Fojtik JP et al: The diagnosis of aortic dissection by emergency medicine ultrasound. J Emerg Med. 32(2):191-6, 2007
                                    8. Trimarchi S et al: Acute abdominal aortic dissection: insight from the International Registry of Acute Aortic Dissection (IRAD). J Vasc Surg. 46(5):913-919, 2007
                                    9. Hirsch AT et al: ACC/AHA 2005 Practice guidelines for the management of patients with peripheral arterial disease: a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines: endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation. 113(11):e463-654, 2006
                                    10. U.S. Preventive Services Task Force: Screening for abdominal aortic aneurysm: recommendation statement. Ann Intern Med. 142(3):198-202, 2005
                                    11. Farber A et al: Isolated dissection of the abdominal aorta: clinical presentation and therapeutic options. J Vasc Surg. 36(2):205-10, 2002
                                    12. Hagan PG et al: The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA. 283(7):897-903, 2000
                                    13. Thomas EA et al: Duplex ultrasound of the abdominal aorta--a neglected tool in aortic dissection. Clin Radiol. 42(5):330-4, 1990
                                    14. Conrad MR et al: Real time ultrasound in the diagnosis of acute dissecting aneurysm of the abdominal aorta. AJR Am J Roentgenol. 132(1):115-6, 1979
                                    15. Winsberg F et al: Continuous ultrasound "B" scanning of abdominal aortic aneurysms. Am J Roentgenol Radium Ther Nucl Med. 121(3):626-33, 1974
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Clinical Issues

                                          TERMINOLOGY

                                          • Abbreviations

                                            • Abdominal aortic dissection (AAD)
                                          • Definitions

                                            • Intimal tear of abdominal aorta (inferior to diaphragm) with blood/clot separating intima and media, creating 2 distinct lumina

                                          IMAGING

                                          • General Features

                                            • Ultrasonographic Findings

                                              • Radiographic Findings

                                                • CT Findings

                                                  • MR Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          CLINICAL ISSUES

                                                          • Presentation

                                                            • Demographics

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  DIAGNOSTIC CHECKLIST

                                                                  • Image Interpretation Pearls

                                                                    • Reporting Tips

                                                                      Selected References

                                                                      1. Nauta FJ et al: Update in the management of type B aortic dissection. Vasc Med. 21(3):251-63, 2016
                                                                      2. Guirguis-Blake JM et al: Ultrasonography screening for abdominal aortic aneurysms: a systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med. 160(5):321-9, 2014
                                                                      3. Roger VL et al: Heart disease and stroke statistics--2012 update: a report from the American Heart Association. Circulation. 125(1):e2-e220, 2012
                                                                      4. Criado FJ: Aortic dissection: a 250-year perspective. Tex Heart Inst J. 38(6):694-700, 2011
                                                                      5. McMahon MA et al: Multidetector CT of aortic dissection: A pictorial review. Radiographics. 30(2):445-60, 2010
                                                                      6. Jonker FH et al: Dissection of the abdominal aorta. Current evidence and implications for treatment strategies: a review and meta-analysis of 92 patients. J Endovasc Ther. 16(1):71-80, 2009
                                                                      7. Fojtik JP et al: The diagnosis of aortic dissection by emergency medicine ultrasound. J Emerg Med. 32(2):191-6, 2007
                                                                      8. Trimarchi S et al: Acute abdominal aortic dissection: insight from the International Registry of Acute Aortic Dissection (IRAD). J Vasc Surg. 46(5):913-919, 2007
                                                                      9. Hirsch AT et al: ACC/AHA 2005 Practice guidelines for the management of patients with peripheral arterial disease: a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines: endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation. 113(11):e463-654, 2006
                                                                      10. U.S. Preventive Services Task Force: Screening for abdominal aortic aneurysm: recommendation statement. Ann Intern Med. 142(3):198-202, 2005
                                                                      11. Farber A et al: Isolated dissection of the abdominal aorta: clinical presentation and therapeutic options. J Vasc Surg. 36(2):205-10, 2002
                                                                      12. Hagan PG et al: The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA. 283(7):897-903, 2000
                                                                      13. Thomas EA et al: Duplex ultrasound of the abdominal aorta--a neglected tool in aortic dissection. Clin Radiol. 42(5):330-4, 1990
                                                                      14. Conrad MR et al: Real time ultrasound in the diagnosis of acute dissecting aneurysm of the abdominal aorta. AJR Am J Roentgenol. 132(1):115-6, 1979
                                                                      15. Winsberg F et al: Continuous ultrasound "B" scanning of abdominal aortic aneurysms. Am J Roentgenol Radium Ther Nucl Med. 121(3):626-33, 1974