Das akute Aortensyndrom

Zusammenfassung

Das akute Aortensyndrom ist der neue Oberbegriff fuer akute Erkrankungen der Aortenwand und umfasst sowohl Dissektion, intramurale Einblutung und Ulkusformation, als auch Traumatisierung der Gefaesswand mit einer jaehrlichen Inzidenz bis zu 35/100.000 im Alterssegment zwischen 65 und 75 Jahren. Histopathologisch nachweisbare Schaeden und eine genetische Disposition sind entscheidend fuer die Entstehung des Aortensyndroms, waehrend die anatomische Lokalisaton massgeblich ist fuer die Therapie mit chirurgischen Massnahmen im proximalen Abschnitt der Aorta und endovaskulaer-interventionellen Verfahren fuer den Bogen und die descendierende Aorta; in allen Faellen von Wanddissektion (sowohl im proximalen als auch distalen Segment) ist die Rekonstruktion der dissezierten Aorta Voraussetzung fuer eine langfristig verbesserte Prognose.

Abstract

Acute aortic syndrome is the common denominator for acute events to the aortic wall and encompasses dissection of the aorta, intramural hematoma, formation of aortic ulcers and trauma to the aorta with an annual incidence of up to 35 cases/100.000 between 65 and 75 years of age. Both, inflammation and/or microtrauma at the level of the aortic media layer, and a genetic disposition are promoting elements of AAS, while the extent and anatomic involvement of the ascending aorta call for either surgical resection/repair in the proximal part of the aorta, or an endovascular solution for pathologies in the distal aorta; in all cases of dissection (regardless of location) reconstruction/realignment has been proven to portend better long-term outcomes (in addition to medical management of blood pressure).

Schlüsselwörter

akutes Koronarsyndrom - Aortendissektion

Keywords

acute coronary syndrome - aortic dissection

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