4.6 Review

Acute aortic syndromes: An internist's guide to the galaxy

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Makoto Hibino et al.

Summary: This study investigated the association between hypertension and aortic dissection (AD), and conducted a meta-analysis. The results showed that hypertension and elevated systolic and diastolic blood pressure were associated with an increased risk of AD.

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Legumain Is an Endogenous Modulator of Integrin αvβ3 Triggering Vascular Degeneration, Dissection, and Rupture

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Summary: The role of legumain (LGMN) in thoracic aortic dissection (TAD) development and vascular smooth muscle cell (VSMC) differentiation was investigated. Elevated LGMN levels were observed in aorta and sera from TAD patients and in BAPN-induced TAD model mice. LGMN was found to regulate VSMC phenotype transformation and its inhibition ameliorated TAD progression.

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Systemic immune-inflammation index predicted the clinical outcome in patients with type-B aortic dissection undergoing thoracic endovascular repair

Sheng Su et al.

Summary: This study found that the systemic immune-inflammation index (SII) is associated with short-term and long-term outcomes in patients with type-B aortic dissection (TBAD) undergoing thoracic endovascular repair (TEVAR) through retrospective analysis.

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Systemic immune-inflammation index predicted short-term outcomes in ATAD patients undergoing surgery

Hongjie Xu et al.

Summary: This study evaluated the value of SII in predicting short-term outcomes in patients with acute type A aortic dissection (ATAD) undergoing surgery. The results showed that high SII was associated with increased risk of 30-day mortality and major complications after surgery. However, SII was not able to predict the length of stay in the intensive care unit and hospital.

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Daisuke Arima et al.

Summary: This study evaluated the relationship between preoperative DIC levels and treatment outcomes in patients with acute type A aortic dissection (ATAAD). The results suggest that high preoperative JAAM DIC scores are associated with a large false lumen and communicating-type ATAAD.

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Saul Lovatt et al.

Summary: This article reviews the main reasons for misdiagnosis of aortic dissection. The study found that the misdiagnosis rate of aortic dissection reached 33.8%. Chest pain, back pain, and syncope are common symptoms of aortic dissection. Factors such as pre-existing hypertension, smoking, and coronary artery disease are associated with misdiagnosis. Improving the collection of medical history and using imaging can improve the accuracy of diagnosing aortic dissection.

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Efficacy of CRP in combination with D-dimer in predicting adverse postoperative outcomes of patients with acute Stanford type A aortic dissection

Zhiwei Tang et al.

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Diagnosis and management of acute aortic syndromes in the emergency department

Fulvio Morello et al.

Summary: AAS are deadly cardiovascular emergencies involving the thoracic aorta, requiring CTA for diagnosis and treatment. Misdiagnosis and delayed diagnosis are major concerns, and treatment includes medical therapy and potentially urgent surgery.

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Development and Validation of a Simplified Probability Assessment Score Integrated With Age-Adjusted D-Dimer for Diagnosis of Acute Aortic Syndromes

Fulvio Morello et al.

Summary: The study identified a simplified scoring tool (AORTAs) that increases sensitivity, improves AAS classification, and makes minor adjustments in specificity, amenable to integration with age-adjusted DD for diagnostic rule-out.

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Additional risk factors for evaluation of suspected acute aortic syndromes in the emergency department

Peiman Nazerian et al.

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R. Wilson King et al.

Summary: Acute aortic syndromes encompass various life-threatening aortic pathologies, with prompt diagnosis and proper management playing a crucial role in reducing mortality and morbidity. Type A dissections necessitate urgent surgical treatment, while treatment for Type B dissections depends on whether they are complicated or uncomplicated.

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Aggrecan: a new biomarker for acute type A aortic dissection

Karl C. Koenig et al.

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SCIENTIFIC REPORTS (2021)

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The potential value of the neutrophil to lymphocyte ratio for early differential diagnosis and prognosis assessment in patients with aortic dissection

Haixia Zhang et al.

Summary: The study found that the neutrophil to lymphocyte ratio (NLR) could serve as a valuable clinical biomarker for diagnosing suspected aortic dissection (AD) and predicting in-hospital mortality risk. An NLR above 5.67 was useful for distinguishing AD patients, while a higher NLR was associated with increased risk of in-hospital mortality prediction.

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Giovanni Ascione et al.

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Wall Shear Stress Assessment of the False Lumen in Acute Type B Aortic Dissection Visualized by 4-Dimensional Flow Magnetic Resonance Imaging: An Ex-Vivo Study

Hugo T. C. Veger et al.

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Neutrophil to lymphocyte ratio and fibrinogen values in predicting patients with type B aortic dissection

Shuangshuang Li et al.

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The effect of beta-blockers on hemodynamic parameters in patient-specific blood flow simulations of type-B aortic dissection: a virtual study

Mohammad Amin Abazari et al.

Summary: The study reconstructed patient-specific geometry of type-B AD and implemented numerical simulation using CFD. Results showed that controlling TAWSS and HOLMES values can prevent lesions and control calcification and plaque formation.

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Endovascular ascending aortic repair in type A dissection: A systematic review

Yunus Ahmed et al.

Summary: This study provides a comprehensive overview of catheter-based interventions in patients with acute type A aortic dissection, showing that endovascular repair is feasible with high technical success and acceptable short-term outcomes, despite higher rates of reintervention and endoleak. Further studies with longer follow-up and careful patient selection are needed before endovascular interventions can be widely introduced.

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Risk score system for late aortic events in patients with uncomplicated type B aortic dissection

Akihito Matsushita et al.

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Brett J. Carroll et al.

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Yusuke Tsutsumi et al.

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Jung-Min Ahn et al.

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Redefining the histopathologic profile of acute aortic syndromes: Clinical and prognostic implications

Ornella Leone et al.

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Emergency physician focused cardiac ultrasound improves diagnosis of ascending aortic dissection

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