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Aortic dissection; Stanford type B dissection of the descending part of the aorta (3), which starts from the left subclavian artery and extends to the abdominal aorta (4). The ascending aorta (1) and aortic arch (2) shown in the image are not involved in this condition.
Familial aortic dissection or FAD refers to the splitting of the wall of the aorta in either the arch, ascending or descending portions. FAD is thought to be passed down as an autosomal dominant disease and once inherited will result in dissection of the aorta, and dissecting aneurysm of the aorta, or rarely aortic or arterial dilation at a young age.
Aortography involves placement of a catheter in the aorta and injection of contrast material while taking X-rays of the aorta.The procedure is known as an aortogram. The diagnosis of aortic dissection can be made by visualization of the intimal flap and flow of contrast material in both the true lumen and the false lumen.
Abdominal aortic endograft on a CT scan; original aneurysm marked in blue The procedure is carried out in a sterile environment under fluoroscopic guidance. It is usually carried out by a vascular surgeon , interventional radiologist or cardiac surgeon , and occasionally, general surgeon or interventional cardiologist .
A CT scan or MRI is taken of a patient to obtain the geometry of the aorta. The information from that scan is then used to create a physical model made from a transparent silicone material. [11] The material used can either be compliant, in order to replicate the dilation of the valve, or rigid.
The lateral aortic lymph nodes, typically 15 to 20 on each side, are the ones usually chosen for dissection or biopsy in the treatment or diagnosis of cancer. A dissection usually includes the region from the bifurcation of the aorta to the superior mesenteric artery or the renal veins.
A thoracic aortic aneurysm is an aortic aneurysm that presents primarily in the thorax. A thoracic aortic aneurysm is the "ballooning" of the upper aspect of the aorta, above the diaphragm. Untreated or unrecognized they can be fatal due to dissection or "popping" of the aneurysm leading to nearly instant death.
The diagnosis of an abdominal aortic aneurysm can be confirmed by the use of ultrasound. Rupture may be indicated by the presence of free fluid in the abdomen. A contrast-enhanced abdominal CT scan is the best test to diagnose an AAA and guide treatment options. [14]