#Irad aortic dissection classification windows#

In younger patients, ionizing radiation can be avoided, and the contrast agent is not nephrotoxic. MRA is another useful imaging modality in the evaluation of TAA. Although generally safe, the main risk of CTA is the associated ionizing radiation and nephrotoxic contrast. It is readily available, noninvasive, and allows for rapid, high-resolution imaging of the entire aorta and branch vessels. The most common imaging modality to evaluate the entirety of the thoracic aorta is CTA.

#Irad aortic dissection classification windows#

Transesophageal echocardiography can visualize more of the distal aorta, but there are windows that are obscured by the bronchi, and the test is semi-invasive. Transthoracic echocardiography offers excellent visualization of the root and ascending aorta but is limited in its ability to evaluate the descending thoracic aorta. The majority of patients are incidentally diagnosed on thoracic imaging, as only 5% of patients are symptomatic on presentation. Histologically, most aneurysms are characterized by medial degeneration. Genetically mediated connective tissue disorders such as Marfan syndrome, Loeys-Dietz syndrome, and Ehlers-Danlos syndrome type IV can commonly lead to thoracic aneurysm formation. The most common predisposing factors include systemic hypertension, atherosclerosis, and chronic obstructive pulmonary disease. The majority of aneurysms are fusiform, although saccular aneurysms can arise, particularly in the setting of a penetrating aortic ulcer (PAU). 2 The prevalence at autopsy is roughly 3%, with a 2:1 male preponderance. Approximately 60% involve the ascending aorta and 40% involve the descending aorta. Thoracic aortic aneurysms (TAAs) are typically described according to their location.

This article describes the classification of acute and chronic diseases of the thoracic aorta. This appearance showed the true state of an incipient aneurysm of the aorta.” 1 Since then, elucidation of the pathophysiology, advances in imaging, and the establishment of clinical databases such as the International Registry of Acute Aortic Dissection (IRAD) have enhanced our understanding of the disease processes affecting the thoracic aorta. “In the trunk of the aorta, we found a transverse sissure on its inner side, about an inch and a half long, through which some blood had recently passed, under its external coat, and formed an elevated ecchymosis. One of the earliest pathologic descriptions of a ruptured acute aortic dissection was by Frank Nicholls, who performed the autopsy of King George II of England. Physicians have known about diseases of the thoracic aorta for centuries.