Thoracic aortic aneurysm

S. E., Shete, S. S., and Milewicz, D. M. (2003). Mapping a locus for familial thoracic aortic aneurysms and dissections (TAAD2) to 3p24-25. Circulation 107, 3184-3190. 

Dake M.D., Miller D.C., Semba C.P. et al. 1994. Transluminal placement of endovascular stent-grafts for the treatment of descending thoracic aortic aneurysms. N. Engl. J. Med. 331 1729-34. 

The Palmaz stent as a balloon expandable stent has a specific complication profile. Once the stent is compressed due to extrinsic forces, e.g., an enlarging tumor mass, adjacent vascular structures, or a vigorous cough, it has no abihty to reexpand. Compression of a Palmaz stent has been noted in a patient with a thoracic aortic aneurysm (Slonim et al. 1998), in a patient after severe coughing (Hautmann and Huber 1996), and in two patients with external malignant tumors (Beer et al. 1999). 

Clinical Applications 300 Aortic Aneurysm 300 Thoracic Aortic Aneurysm 300 Abdominal Aortic Aneurysm 302 Inflammatory Aortic Aneurysm 303 Aortic Dissection 304 Stanford A Dissection 305 Stanford B Dissection 305 Penetrating Aortic Ulcer 306 IMH 306 Aortitis 307 Injury of the Aorta 307 CTA in Endovascular Aortic Reconstruction 308... 

Thoracic aortic aneurysm (TAA) is defined as a persisting dilatation of the ascending aorta larger than 4 cm and of the descending aorta larger than 3 cm (Issel-... 

Multiple sclerosis Preganglionic Spinal birth injury Tuberculosis Pancoast tumor Aortic aneurysm Enlarged mediastinal glands Enlargement of thyroid Lymphadenopathy Thoracic neuroblastoma Pulmonary mucormycosis Trauma... 

Figure 7.4 (A) A patient with thoracic pain due to a dissecting aortic aneurysm. An ST-segment elevation in V1-V3 can be explained by the mirror pattern of an evident LVE (V6) due to hypertension. This ST-segment elevation has been erroneously interpreted as due to an acute coronary syndrome. As a consequence, fibrinolytic...

The final chapter of the book is focused on stent grafts that provide the currently preferred and less invasive endovascular therapy for treating thoracic and abdominal aortic aneurysms. This is a comparatively recent development that has brought interventional radiologists into the same operating room as vascular surgeons, which has led to a reappraisal of the role of each type of specialist in providing vascular therapy. Details about the materials, clinical performance, current issues and future directions are all described in Chapter 21. 

Anon, lypes of aortic aneurysms. Heart, Vascular and Thoracic Care. University of Wisconsin - Madison, School of Medicine and Pubhc Health. 3/11/2013,2013, from http //www.uwhealth.org/heart-cardiovascular/types-of-aortic-aneurysms/ 10973... 

MSCT with M1P and VR may diagnose a traumatic or non-traumatic ruptured thoracic and abdominal aortic aneurysm on the basis of a contrast-enhanced CT scan that shows an aortic aneurysm with adjacent periaortic hemorrhage (Fig. 25.4) and may depict active bleeding, the extension of the aneurysm, the presence and extent of mural thrombosis and the stenosis or occlusion of vessels. For interventional stent repair, most of the measurements for determination of the optimal dimension and type of stent-graft are obtained with MSCT and 3D reconstructions. 

Fig. 23.4. Modified classification of thoracic and abdominal aortic aneurysms by Crawford. Type I distal of the left subclavian artery as far as the renal arteries type II distal of the left subclavian artery, extending below the renal arteries type III from the sixth thoracic vertebral body, extending below the re-...

Fig. 23.5. Partially calcified thoracic and abdominal aortic aneurysm in a patient with Marfan syndrome. Coronary VR (left) and MPR (right)...

Isselbacher EM (2005) Thoracic and abdominal aortic aneurysms. Circulation 111 816-828... 

Takahashi K, Stanford W (2005) Multidetector CT of the thoracic aorta. Int J Cardiovasc Imaging 21 141-153 Tang T, Boyle JR, Dixon AK, Varty K (2005) Inflammatory abdominal aortic aneurysms. Eur J Vase Endovasc Surg... 

Among the non-ischaemic cardiovascular causes of thoracic pain that should be ruled out, some present a benign prognosis as pericarditis, while others, in turn, point to a much serious prognosis, such as an acute aortic syndrome (dissecting aneurysm or other aortic pathologies) and a pulmonary embolism. On the whole, these account for 5-10% of all cases of thoracic pain. 

AAAs present in three different types or shapes. Fusiform aneurysms, the most typical, are mostly symmetrical bulges that occur around the entire circumference of the aorta. These are sometimes referred to as false aneurysms or pseudoaneurysms, because layers of the wall of the aorta are missing (as opposed to the presence of all three layers in a true aneurysm). An aortic dissection, on the other hand, is when blood penetrates the inner layer of the aortic wall, and flows between the layers, similar to delamination. This typically occurs in the thoracic region of the aorta, but can sometimes occur in the abdominal region. Figure 21.3 shows these various types of aneurysms. 

The thoracic aorta may be affected by several different diseases, such as aortic dissection, intramural hematoma, penetrating atherosclerotic ulcer, aneurysms and traumatic injury. Any of these diseases may well be displayed in the axial slices, as well with post-processing (Takahashi and Stanford 2005). Volume rendering in particular is helpful in displaying the anatomical situation of the thoracic aorta after stent graft placement (Fig. 15.7). 

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