Materiały źródłowe

• #1 Preventing Aortic Dissection | NYU Langone Health

  https://nyulangone.org/conditions/aortic-dissection/prevention

  You can reduce your risk of aortic dissection by making lifestyle changes that include monitoring and controlling your blood pressure, maintaining a healthy weight, quitting smoking, and wearing a seatbelt while in a car. […] Keeping your blood pressure under control is the best way to help prevent an aortic dissection. […] To maintain a healthy weight, doctors recommend following a balanced, nutritious diet and getting regular exercise. […] Smoking can raise blood pressure. […] You can help protect your chest by wearing a seat belt every time you ride in a car.

• #1 Aortic dissection – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/aortic-dissection/symptoms-causes/syc-20369496

  You can reduce your risk of an aortic dissection by preventing chest injury and taking steps to keep your heart healthy. […] Control blood pressure. If you have high blood pressure, get a home blood pressure measuring device to help you monitor your blood pressure. […] Don’t smoke. If you do smoke, take steps to stop. […] Maintain an ideal weight. Follow a low-salt diet with plenty of fruits, vegetables and whole grains and exercise regularly. […] Wear a seat belt. This reduces the risk of chest injury during a car accident. […] Work with your doctor. If you have a family history of aortic dissection, a connective tissue disorder or a bicuspid aortic valve, tell your doctor. If you have an aortic aneurysm, find out how often you need monitoring and if surgery is necessary to repair your aneurysm. […] If you have a genetic condition that increases your risk of aortic dissection, your doctor may recommend medications, even if your blood pressure is normal.

• #1 Prevention of Aortic Dissection | SpringerLink

  https://link.springer.com/chapter/10.1007/978-0-387-36001-0_18

  The best way to prevent aortic dissection is optimal control of blood pressure, even for people with inherited forms of aortic wall weakness. […] Beta blockers are the antihypertensive agents of choice in individuals at risk for aortic dissection. […] Current guidelines recommend titration of these agents to achieve a heart rate of 60 beats per minute and a blood pressure 135/80 mmHg in usual patients and 130/80 mmHg in those with Marfans syndrome.

• #1 Preventing Acute Aortic Dissections: The Power of Familial Screening and Risk Assessment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9238455/

  The natural history of aortic aneurysms involving the root and/or ascending aorta is to progressively and asymptomatically enlarge over time. If aneurysms are not diagnosed, progressive growth over time often leads to an acute type A dissection that requires emergent surgical repair or results in sudden death. However, if atrisk individuals are identified before dissections occur, ascending aortic aneurysms can be repaired to prevent dissectionrelated mortalities. […] However, the optimal strategy for identifying individuals in the general population with increased risk of thoracic aortic disease (TAD) remains a challenge. […] Highly penetrant forms of thoracic aortic disease in individuals with or without syndromic features, collectively termed heritable thoracic aortic disease (HTAD), can be identified by molecular genetic testing, family history analysis, and phenotypic evaluation. HTAD is a genetically heterogeneous condition, associated with 11 clinically actionable genes to date. Professional guidelines and practice statements support genetic testing to confirm molecular diagnosis, tailor aortic surveillance and surgical management, and identify atrisk relatives. […] If a pathogenic variant is identified, predictive cascade genetic testing can be used to definitively determine TAD risk in relatives.

• #1 What should you know about Aortic Dissection? – CTVS Texas

  https://ctvstexas.com/what-should-you-know-about-aortic-dissection/

  Preventing Aortic Dissection […] „The primary driver for aortic dissection is uncontrolled hypertension, and individuals with hypertension should have regular follow-up with their primary care physician,” urges Dr. Felger. […] He also suggests keeping a daily log of your blood pressure and scheduling regular check-ups with heart specialists if you are at risk for cardiovascular disease.

• #1 Causes, Prevention, & Early Detection

  https://med.uth.edu/cvs/patient-care/conditionsandprocedures/aortic-dissection/causes-prevention-early-detection/

  The U.S. Preventive Services Task Force, an independent, volunteer panel of national experts in disease prevention and evidence-based medicine, recommends that men aged 6575 years who have ever smoked, be screened for abdominal aortic aneurysms, even if they have no symptoms. […] People living with aortic disease, or who have a family history of aortic disease should be proactive with their health and report any symptoms immediately. It is important to get regular check-ups, and always take care of your overall heart health.

• #1 Acute aortic dissection

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-12/Acute-aortic-dissection

  Oral beta-blocker: All patients should receive lifelong therapy with an oral beta-blocker to reduce a) systemic blood pressure and b) the rate of rise in systolic pressure. Both effects of will minimise aortic wall stress. […] Avoid strenuous physical activity […] Thoracic magnetic resonance: A baseline thoracic magnetic resonance scan before discharge, with serial follow-up examinations at three, six and 12 months, even if the patient remains asymptomatic, is recommended.

• #1 Treatment guidelines for thoracic aortic aneurysms and dissections based on the underlying causative gene

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3584588/

  Thoracic aortic aneurysms leading to acute aortic dissections (TAAD) are a common cause of premature death in the United States. The mainstay of prevention of aortic dissection is surgical repair when the aortic diameter expands to 5.5 cm or more. […] Preventing premature deaths necessitates identifying individuals at risk for aortic dissection, carefully monitoring the diameter of the ascending aorta, and performing timely elective surgical repair. […] Current data suggest that the underlying mutation also dictates the risk for further vascular disease beyond the ascending thoracic aorta. […] Therefore, the recommendation for surgical repair of an aortic aneurysm when the diameter reaches 4.2 cm applies to both LDS and FTAAD patients. […] If family members have experienced dissections at aortic diameters less than 5.0 cm, then surgical repair for other affected family members at diameters below 5.0 cm should be considered.

• #1 Medication for Aortic Dissection | NYU Langone Health

  https://nyulangone.org/conditions/aortic-dissection/treatments/medication-for-aortic-dissection

  Type B dissections typically respond well to medical treatment that decreases the stress of blood pressure on the aortic wall. This reduces pain from the aortic dissection and helps prevent the tear from worsening. […] Beta blockers are often the first treatment for a type B aortic dissection. […] Sometimes, doctors prescribe beta blockers, which lower heart rate, to prepare the aorta for surgery. […] Taking aspirin, which can cause bleeding, can be fatal in someone with an aortic dissection and is never advised.

• #1 Anticoagulant and anti-thrombotic therapy in acute type B aortic dissection: when real-life scenarios face the shadows of the evidence-based medicine | BMC Cardiovascular Disorders | Full Text

  https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-020-01342-2

  Evidence-based recommendations about anticoagulation in acute type B aortic dissection (TBAD) are completely missing, but there is a diffuse conviction that it could prevent the healing process of the dissected aortas false lumen. […] Current guidelines do not discuss anticoagulant therapy in the setting of TBAD and large randomized trials are lacking. Despite it is generally considered unsafe to administer anticoagulants in patients with TBAD, we present a case in which triple antithrombotic therapy was well tolerated and did not lead to progression of the intimal flap after 6 months. […] This lack of data is further attested by a relevant interdisciplinary expert consensus on management of type B aortic dissection giving no information about anticoagulation/antiplatelet therapy in this scenario, also due to the large heterogeneity existing among different studies.

• #1 Acute aortic dissection

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-12/Acute-aortic-dissection

  Preventive measures of before and after the events of aortic dissection are: […] Treatment of hypertension […] Elective aortic surgery in patients with dilated ascending aortas. Guidelines for timing of aortic root repair are based on clinical observations by experienced clinicians and surgeons, and consensus. One consensus is that surgery to prevent rupture or dissection of the ascending TAA should be recommended when the ascending aortic diameter reaches 5.5 cm for non-Marfan patients and 4.5 cm in Marfan patients. […] Marfan syndrome: reduced physical activity endocarditis prophylaxis, serial imaging of the aorta, beta-blocker medication for aortic protection and prophylactic replacement of the aortic root. Prophylaxis surgery: At least one criteria must be met among the following

• #1 Aortic Dissection Research Priorities in the UK & Ireland

  https://aorticdissectionawareness.org/research/priorities

  Prevention of aortic dissection through improved identification, screening and monitoring of those at risk of the condition is a key priority for patients and their families. We encourage further research into topics including: […] Improved genetic screening and surveillance of the relatives of aortic dissection patients […] Better monitoring and screening of people with hypertension […] More effective monitoring and understanding of syndromic forms of aortic disease […] Better understanding of the risks of aortic dissection related to pregnancy.

• #1 Aortic Dissection – Vascular Specialists of Central Florida

  https://arteryandvein.com/aortic-dissection/

  Aortic dissection is a serious, critical condition that needs treatment right away. […] For those patients who survive the dissection, the five-year survival rate is roughly 60%, and the ten-year survival rate at 40%. Many patients who survive the initial episode are often prescribed beta-blockers for the rest of their lives, as well as undergo regular CAT scans or MRIs to track their condition. […] Certain cases of aortic dissection cannot be prevented. However, there are things one can do to reduce ones chances of developing it: Treating atherosclerosis, controlling hypertension and frequent monitoring of ones blood pressure, quitting smoking, maintaining an optimal body weight, exercise regularly, and follow a healthy diet with sufficient fruits and vegetables, working closely with ones physician, especially when a genetic history of heart condition, aortic dissection or connective tissue disease is involved.

• #1 Review on Acute Aortic Dissection: Key Points

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2023/01/03/20/08/acute-aortic-dissection

  Aortic dissection is an acute process in which a tear in the aortic intimal layer causes the intima and media to separate from the adventitia, resulting in the formation of an aortic false lumen in addition to the existing true lumen. […] Treatment for all aortic dissections should include medical therapy. In the acute setting, intravenous beta-blocking agents should be used to reduce the heart rate and lower the systolic blood pressure to 100-120 mm Hg. In patients with chronic aortic dissection, blood pressure should be maintained below 140/90 mm Hg; along with lifestyle changes that include moderate physical activity, smoking cessation, and a healthy diet. […] Biomarkers could be of use to help accelerate the diagnosis of aortic dissection or as a prognostic marker among patients with chronic aortic dissection. In addition to cardiac troponin I and D-dimer, Aggrecan and an interleukin-1 receptor family member (ST2) have been tested in the diagnosis of acute aortic dissection.

• #1 The Best Practice for Type B Aortic Dissection – Endovascular Today

  https://evtoday.com/articles/2012-nov-supplement/the-best-practice-for-type-b-aortic-dissection

  Although general consensus exists regarding the need of immediate surgical repair for patients with acute ascending aortic dissection (type A dissection), the optimal treatment of type B dissection is still a matter of debate. […] It has been generally recommended that patients who have type B aortic dissection without complications are treated with medical therapy in an intensive care unit. […] Usually, with aggressive antihypertensive therapy, up to 85% of patients may survive their initial hospital stay. […] In addition, keeping the heart rate below 60 bpm significantly decreases secondary adverse events (aortic expansion, recurrent aortic dissection, aortic rupture) compared to a conventional rate of 60 bpm. […] The advent of endovascular treatment of the thoracic aorta has revolutionized the clinical approach to type B aortic dissection, representing a new minimally invasive alternative to traditional surgery for the management of acute thoracic aortic pathologies, even in high-risk patients who could not be considered operative candidates.

• #1 The Best Practice for Type B Aortic Dissection – Endovascular Today

  https://evtoday.com/articles/2012-nov-supplement/the-best-practice-for-type-b-aortic-dissection

  However, aortic remodeling seems to be less effective in chronic dissection with a dilated false lumen, with late aneurysmal degeneration of the thrombosed false lumen reported in 7.8% of cases, suggesting the need for earlier treatment before aortic dilation may occur. […] The INSTEAD study at 2 years does confirm the effectiveness of endovascular therapy for false lumen thrombosis (achieved in 90% of cases) and strengthens the role of a tight blood pressure control and close surveillance. […] According to this approach, all patients who do not respond to medical treatment showing progressive false lumen expansion could be treated with a stent graft because even deferred endovascular therapy is feasible.

• #1 Aortic dissection Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/aortic-dissection

  Many cases of aortic dissection cannot be prevented. […] Things you can do to reduce your risk include: […] Treating and controlling hardening of the arteries (atherosclerosis) […] Keeping high blood pressure under control, especially if you are at risk for dissection […] Taking safety precautions to prevent injuries that can cause dissections […] If you have been diagnosed with Marfan or Ehlers-Danlos syndrome, making sure you regularly follow-up with your provider.

• #2 Aortic dissection – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/aortic-dissection/symptoms-causes/syc-20369496

  You can reduce your risk of an aortic dissection by preventing chest injury and taking steps to keep your heart healthy. […] Control blood pressure. If you have high blood pressure, get a home blood pressure measuring device to help you monitor your blood pressure. […] Don’t smoke. If you do smoke, take steps to stop. […] Maintain an ideal weight. Follow a low-salt diet with plenty of fruits, vegetables and whole grains and exercise regularly. […] Wear a seat belt. This reduces the risk of chest injury during a car accident. […] Work with your doctor. If you have a family history of aortic dissection, a connective tissue disorder or a bicuspid aortic valve, tell your doctor. If you have an aortic aneurysm, find out how often you need monitoring and if surgery is necessary to repair your aneurysm. […] If you have a genetic condition that increases your risk of aortic dissection, your doctor may recommend medications, even if your blood pressure is normal.

• #2 Aortic Dissection – UChicago Medicine

  https://www.uchicagomedicine.org/conditions-services/heart-vascular/aortic-disease/aortic-dissection

  Having a long-term blood pressure management plan is critical for aortic dissection prevention. Getting and keeping control over your blood pressure will protect your aorta from complications that could leave to serious, or fatal, damage. […] The best defense against aortic dissection is knowing what risk factors are common with this condition and taking active steps to eliminate or reduce your known risks in order to minimize your chances of serious aortic disease.

• #2 Prevention of Aortic Dissection | SpringerLink

  https://link.springer.com/chapter/10.1007/978-0-387-36001-0_18

  The best way to prevent aortic dissection is optimal control of blood pressure, even for people with inherited forms of aortic wall weakness. […] Beta blockers are the antihypertensive agents of choice in individuals at risk for aortic dissection. […] Current guidelines recommend titration of these agents to achieve a heart rate of 60 beats per minute and a blood pressure 135/80 mmHg in usual patients and 130/80 mmHg in those with Marfans syndrome.

• #2 Medication for Aortic Dissection | NYU Langone Health

  https://nyulangone.org/conditions/aortic-dissection/treatments/medication-for-aortic-dissection

  Type B dissections typically respond well to medical treatment that decreases the stress of blood pressure on the aortic wall. This reduces pain from the aortic dissection and helps prevent the tear from worsening. […] Beta blockers are often the first treatment for a type B aortic dissection. […] Sometimes, doctors prescribe beta blockers, which lower heart rate, to prepare the aorta for surgery. […] Taking aspirin, which can cause bleeding, can be fatal in someone with an aortic dissection and is never advised.

• #2 Abdominal aortic aneurysm – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/abdominal-aortic-aneurysm/symptoms-causes/syc-20350688

  To prevent an abdominal aortic aneurysm or to keep one from worsening, take these steps: […] Don’t smoke or use tobacco products. If you smoke or chew tobacco, quit. Also avoid secondhand smoke. If you need help quitting, talk to your healthcare team about strategies that may help. […] Eat a healthy diet. Choose a variety of fruits and vegetables, whole grains, chicken, fish, and low-fat dairy products. Avoid saturated and trans fats and limit salt. […] Keep your blood pressure and cholesterol under control. Take medicines as directed. […] Get regular exercise and stay active. Try to get at least 150 minutes a week of moderate aerobic activity. If you haven’t been active, start slowly and build up. Talk to your healthcare team about what kinds of activities are right for you.

• #2 Treatment guidelines for thoracic aortic aneurysms and dissections based on the underlying causative gene

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3584588/

  Thoracic aortic aneurysms leading to acute aortic dissections (TAAD) are a common cause of premature death in the United States. The mainstay of prevention of aortic dissection is surgical repair when the aortic diameter expands to 5.5 cm or more. […] Preventing premature deaths necessitates identifying individuals at risk for aortic dissection, carefully monitoring the diameter of the ascending aorta, and performing timely elective surgical repair. […] Current data suggest that the underlying mutation also dictates the risk for further vascular disease beyond the ascending thoracic aorta. […] Therefore, the recommendation for surgical repair of an aortic aneurysm when the diameter reaches 4.2 cm applies to both LDS and FTAAD patients. […] If family members have experienced dissections at aortic diameters less than 5.0 cm, then surgical repair for other affected family members at diameters below 5.0 cm should be considered.

• #2 Preventing Acute Aortic Dissections: The Power of Familial Screening and Risk Assessment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9238455/

  Despite professional society guidelines and expert opinion that recommend thoracic aortic imaging for atrisk relatives, additional data are needed to determine the optimal timing to initiate imaging, the preferred imaging modality, and impact of screening programs on health outcomes. […] The success of screening programs also relies on communication with atrisk relatives and the relatives willingness to pursue screening. […] This current study emphasizes the utility of aortic surveillance for atrisk relatives of all patients with TAD, regardless of known family history and age of onset. […] However, we are still challenged to investigate approaches for TAD risk stratification in the general population. Up to 80% of aortic dissection is sporadic in nature and likely driven by interactions between more than 1 genetic risk variant in combination with environmental and lifestyle factors.

• #2 Dissection of the Aorta: Types, Symptoms & Treatment

  https://www.healthline.com/health/heart-disease/aortic-dissection

  The U.S. Preventive Services Task Force recommends that all males ages 65 to 75 years old, who are former or current smokers, receive an ultrasound screening for aortic aneurysms. Early detection is essential to improve your chances of survival if you show signs of the condition. […] If you have cardiac disease or other heart-related conditions, its essential to: Report any symptoms promptly. Get regular check-ups. Always prioritize your heart health through diet and exercise. Take all medications, including blood pressure and cholesterol drugs, as directed by your physician. […] Although aortic dissection is rare, you can take steps to lessen the likelihood that you may experience it. These steps include attending regular medical check-ups, treating risk factors like high blood pressure, and avoiding injuries to your chest.

• #2 Aortic Dissection: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16743-aortic-dissection

  You cant change many of the factors that increase the risk of developing aortic dissection. These include being born with certain heart conditions, connective tissue disorders, or genetic triggers associated with having a family history of aortic dissection. […] But you can decrease some of your risks by: […] Managing your blood pressure. […] Avoiding tobacco products. […] Maintaining a weight thats healthy for you. […] Wearing your seat belt to prevent injury to your chest in case of an accident. […] Seeing your provider for regular checkups and any other times you have a change in your health. […] Asking a provider to assess your risk of aortic disease if a first-degree relative (parent, child or sibling) has had an aortic dissection. A provider can monitor and treat you before an aortic event occurs. […] If you get an aortic aneurysm diagnosis, seek out a healthcare provider (cardiologist or cardiac surgeon) who specializes in aortic disease. Theyll be able to assess your risks and use imaging to carefully monitor you for the need for elective repair of your aorta.

• #2 Concomitant pulmonary embolism and aortic dissection: An approach to anticoagulation | Revista Portuguesa de Cardiologia (English edition)

  https://revportcardiol.org/en-concomitant-pulmonary-embolism-aortic-dissection-articulo-S217420492030249X

  In the authors opinion, the way anticoagulation is managed in an initial phase should include the use of rapid reversal parenteral anticoagulants, such as UFH, due to the possibility of severe bleeding and need for emergent surgery. In a subsequent phase, when considering long-term oral anticoagulation, vitamin K antagonists are a safer choice due to their relatively rapid reversal and support with blood products. However, when considering novel oral anticoagulants, the use of antidotes that reverse their effects almost immediately must also be taken into account. […] The authors recommend that in the case of an uncomplicated Stanford type B AD diagnosis, in which anticoagulant therapy is required due to another concomitant disease, a CTA should be performed in the first 24 hours, before hospital discharge and every three months for the first year, or whenever the patient’s clinical status changes or laboratory analyses are suggestive of acute bleeding or progression of the dissection. From then onwards, follow-up imaging should be performed annually.

• #2 Acute aortic dissection

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-12/Acute-aortic-dissection

  Preventive measures of before and after the events of aortic dissection are: […] Treatment of hypertension […] Elective aortic surgery in patients with dilated ascending aortas. Guidelines for timing of aortic root repair are based on clinical observations by experienced clinicians and surgeons, and consensus. One consensus is that surgery to prevent rupture or dissection of the ascending TAA should be recommended when the ascending aortic diameter reaches 5.5 cm for non-Marfan patients and 4.5 cm in Marfan patients. […] Marfan syndrome: reduced physical activity endocarditis prophylaxis, serial imaging of the aorta, beta-blocker medication for aortic protection and prophylactic replacement of the aortic root. Prophylaxis surgery: At least one criteria must be met among the following

• #2 Aortic dissection – Wikipedia

  https://en.wikipedia.org/wiki/Aortic_dissection

  Prevention is by blood pressure control and smoking cessation. […] Among the recognized risk factors for aortic dissection, hypertension, abnormally high levels of lipids (such as cholesterol) in the blood, and smoking tobacco are considered preventable risk factors. […] Repair of an enlargement of the ascending aorta from an aortic aneurysm or previously unrecognized and untreated aortic dissections is recommended when greater than 5.5 cm (2.2 in) in size to decrease the risk of dissection. Repair may be recommended when greater than 4.5 cm (1.8 in) in size if the person has one of the several connective-tissue disorders or a family history of a ruptured aorta.

• #2 Acute aortic dissection

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-12/Acute-aortic-dissection

  Oral beta-blocker: All patients should receive lifelong therapy with an oral beta-blocker to reduce a) systemic blood pressure and b) the rate of rise in systolic pressure. Both effects of will minimise aortic wall stress. […] Avoid strenuous physical activity […] Thoracic magnetic resonance: A baseline thoracic magnetic resonance scan before discharge, with serial follow-up examinations at three, six and 12 months, even if the patient remains asymptomatic, is recommended.

• #2 Anticoagulant and anti-thrombotic therapy in acute type B aortic dissection: when real-life scenarios face the shadows of the evidence-based medicine | BMC Cardiovascular Disorders | Full Text

  https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-020-01342-2

  The necessity to treat the proximal LAD stenosis with the deployment of a drug-eluting stent in a patient with intraventricular thrombosis required triple antithrombotic treatment; after multidisciplinary assessment, the risk of thromboembolism from the left ventricle and the necessity to treat the coronary lesion were considered to outweigh the potential risk of dissection progression and aortic rupture given by false lumen patency. […] The evidence of a patent false lumen and the uncomplicated course of the aortic dissection after 6 months of antithrombotic therapy show that, along with previous reports, anticoagulation should not be considered an absolute contraindication in every patient with TBAD but needs to be evaluated on a case-by-case basis. […] However, there is a large evidence gap and uncertainty in this context and trials in this arena are urgently needed.

• #2 Medical Management of Acute and Chronic Type B Aortic Dissection – Endovascular Today

  https://evtoday.com/articles/2022-nov/medical-management-of-acute-and-chronic-type-b-aortic-dissection

  An acute type B aortic dissection (TBAD) can be a life-threatening condition of the aorta with increased risk of mortality and morbidity that requires a prompt diagnosis and treatment plan. […] The goal of medical management in all patients with TBAD, regardless of whether they are candidates for surgical or endovascular intervention, is to prevent both acute and chronic complications. […] Although no randomized clinical trials have evaluated the various medical therapies in preventing short-term mortality in acute TBADs, there are promising data from long-term prospective studies, both single center and from the multicenter IRAD cohort. […] Aggressive BP and heart rate control with -blocker and vasodilator therapy is the mainstay of treatment in both acute and chronic TBAD to prevent aortic-related complications including malperfusion syndromes, expansion, and rupture. […] Ongoing longitudinal study evaluating the safety of fluoroquinolone use in patients with chronic TBAD is needed.

• #2 Thoracic Aortic Aneurysm & Aortic Dissection | Marfan Foundation

  https://marfan.org/conditions/familial-aortic-aneurysm/

  Early detection, frequent imaging, and treatment are critical because both aortic aneurysms and dissections increase the risk that the aorta will suddenly burst (rupture), causing massive internal bleeding. Without surgery to prevent aortic rupture, these blood vessel abnormalities can be life-threatening. […] The management of familial thoracic aortic aneurysm and/or dissection requires the coordinated input from a multidisciplinary team of specialists familiar with this condition, including a medical geneticist, cardiologist, and cardiovascular surgeon. […] Medications (drugs) that reduce the stress on the aorta can be helpful. Beta-blockers help lower blood pressure and reduce the force of the heartbeat. They also may help prevent or slow aortic enlargement and reduce the risk of aortic dissection.

• #2 SMT | The John Ritter Foundation For Aortic Health

  https://johnritterfoundation.org/aorticdisease-in-the-blackcommunity/

  Black individuals are disproportionally affected by hypertension (also known as high blood pressure), which is the most common risk factor in aortic dissection. Measures you can take to prevent aortic dissection include screening for hypertension, knowing your family’s medical history, and proper management of your cardiovascular health. […] With proper management and care, most dissections are preventable. The Ritter Rules can help people of all racial and ethnic backgrounds learn to recognize, treat, and prevent thoracic aortic dissection.

• #2 Aortic Dissection – Vascular Specialists of Central Florida

  https://arteryandvein.com/aortic-dissection/

  Aortic dissection is a serious, critical condition that needs treatment right away. […] For those patients who survive the dissection, the five-year survival rate is roughly 60%, and the ten-year survival rate at 40%. Many patients who survive the initial episode are often prescribed beta-blockers for the rest of their lives, as well as undergo regular CAT scans or MRIs to track their condition. […] Certain cases of aortic dissection cannot be prevented. However, there are things one can do to reduce ones chances of developing it: Treating atherosclerosis, controlling hypertension and frequent monitoring of ones blood pressure, quitting smoking, maintaining an optimal body weight, exercise regularly, and follow a healthy diet with sufficient fruits and vegetables, working closely with ones physician, especially when a genetic history of heart condition, aortic dissection or connective tissue disease is involved.

• #2 The Best Practice for Type B Aortic Dissection – Endovascular Today

  https://evtoday.com/articles/2012-nov-supplement/the-best-practice-for-type-b-aortic-dissection

  Although general consensus exists regarding the need of immediate surgical repair for patients with acute ascending aortic dissection (type A dissection), the optimal treatment of type B dissection is still a matter of debate. […] It has been generally recommended that patients who have type B aortic dissection without complications are treated with medical therapy in an intensive care unit. […] Usually, with aggressive antihypertensive therapy, up to 85% of patients may survive their initial hospital stay. […] In addition, keeping the heart rate below 60 bpm significantly decreases secondary adverse events (aortic expansion, recurrent aortic dissection, aortic rupture) compared to a conventional rate of 60 bpm. […] The advent of endovascular treatment of the thoracic aorta has revolutionized the clinical approach to type B aortic dissection, representing a new minimally invasive alternative to traditional surgery for the management of acute thoracic aortic pathologies, even in high-risk patients who could not be considered operative candidates.

• #2 Indomethacin reduces rates of aortic dissection and rupture of the abdominal aorta by inhibiting monocyte/macrophage accumulation in a murine model | Scientific Reports

  https://www.nature.com/articles/s41598-019-46673-z

  Aortic dissection is a life-threatening condition, which is characterised by separation of the constituent layers of the aortic wall. […] In the present study, we investigated whether the anti-inflammatory agent, indomethacin, could inhibit monocyte/macrophage accumulation in the aortic wall and ensuing dissection. […] Indomethacin prevented death from abdominal aortic dissection and decreased incidence of aortic dissection by as high as 40%. […] These results indicate that indomethacin administration reduces rate of onset of aortic dissection in a murine model of the condition. […] The involvement of inflammatory cytokines and cells to onset of aortic dissection suggests the possibility of anti-inflammatory therapies as prevention/treatment against aortic dissection. […] We demonstrated that indomethacin administration was associated with reduced incidence of aortic dissection and less fatal abdominal aortic rupture, and a decrease in monocyte/macrophage accumulation to the abdominal aortic wall. […] Indomethacin administration decreased monocyte/macrophage accumulation in the abdominal aortic wall and reduced monocytic transendothelial migration activity.

• #2 The Best Practice for Type B Aortic Dissection – Endovascular Today

  https://evtoday.com/articles/2012-nov-supplement/the-best-practice-for-type-b-aortic-dissection

  Encouraging initial reports of clinical outcomes achieved by endovascular repair and stent graft implantation to treat type B aortic dissection have also accelerated the adoption of TEVAR. […] Endovascular treatment is advocated when a patient with acute type B aortic dissection presents with signs of aortic rupture at imaging and clinical evaluation shows evidence of severely impaired visceral/ peripheral perfusion or symptoms of clinical instability, such as uncontrolled hypertension, severe hypotension, and recurrent or refractory pain. […] TEVAR provided better outcomes, with 9.3% mortality in patients treated with a stent graft and 33.9% mortality in patients who underwent open surgery. […] On the basis of several reports showing improved survival rates, endovascular repair is becoming the standard treatment for patients with acute complicated type B dissection.

• #2 Aortic Dissection: Symptoms, Causes, Treatment, Prevention

  https://www.verywellhealth.com/aortic-dissection-7975991

  Aortic dissection is not always preventable. However, there are proactive measures you can take to minimize your risk, such as: […] While aortic dissections cannot always be prevented, managing risk factors like atherosclerosis and high blood pressure, taking safety precautions, and seeking regular follow-up care for underlying conditions can help minimize the chances of this life-threatening condition.

• #3 Aortic Dissection: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16743-aortic-dissection

  You cant change many of the factors that increase the risk of developing aortic dissection. These include being born with certain heart conditions, connective tissue disorders, or genetic triggers associated with having a family history of aortic dissection. […] But you can decrease some of your risks by: […] Managing your blood pressure. […] Avoiding tobacco products. […] Maintaining a weight thats healthy for you. […] Wearing your seat belt to prevent injury to your chest in case of an accident. […] Seeing your provider for regular checkups and any other times you have a change in your health. […] Asking a provider to assess your risk of aortic disease if a first-degree relative (parent, child or sibling) has had an aortic dissection. A provider can monitor and treat you before an aortic event occurs. […] If you get an aortic aneurysm diagnosis, seek out a healthcare provider (cardiologist or cardiac surgeon) who specializes in aortic disease. Theyll be able to assess your risks and use imaging to carefully monitor you for the need for elective repair of your aorta.

• #3 Acute aortic dissection

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-12/Acute-aortic-dissection

  Preventive measures of before and after the events of aortic dissection are: […] Treatment of hypertension […] Elective aortic surgery in patients with dilated ascending aortas. Guidelines for timing of aortic root repair are based on clinical observations by experienced clinicians and surgeons, and consensus. One consensus is that surgery to prevent rupture or dissection of the ascending TAA should be recommended when the ascending aortic diameter reaches 5.5 cm for non-Marfan patients and 4.5 cm in Marfan patients. […] Marfan syndrome: reduced physical activity endocarditis prophylaxis, serial imaging of the aorta, beta-blocker medication for aortic protection and prophylactic replacement of the aortic root. Prophylaxis surgery: At least one criteria must be met among the following

• #3 Causes, Prevention and Tests to Diagnose Aortic Dissections | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/heart-and-vascular/conditions-and-treatments/aortic-dissection/causes-and-diagnoses

  Some risk factors cannot be prevented, such as a family history of aneurysms. […] However, there are some behaviors that can lower your risk of a thoracic aortic aneurysm and dissection, including: […] Monitoring and managing your blood pressure and cholesterol […] Not smoking cigarettes, using vape pens or any other tobacco products […] Exercising regularly […] Eating a healthy diet.

• #3 Aortic Dissection | Heart and Vascular

  https://health.ucdavis.edu/conditions/aortic-dissection

  Aortic dissection is not always preventable, especially if you have certain genetic conditions. […] Lowering your blood pressure and heart rate may help prevent aortic dissection, since it’s a key risk factor. If you have high blood pressure or a high heart rate, you can work with your physician to bring these levels down. […] Steps you can take include: […] Eating a healthy diet […] Getting in a routine of gentle aerobic exercise […] Maintaining a healthy weight […] Quitting smoking […] Taking medications as directed […] Avoiding heavy weightlifting and other strenuous activities.

• #3 How to Prevent a Potentially Fatal Aortic Dissection

  https://vascularinstitute.com/blog/13285/How-to-Prevent-a-Potentially-Fatal-Aortic-Dissection

  High blood pressure is the most common cause of aortic dissections, a condition whose symptoms can be mistaken for a stroke or heart attack and are often fatal. While some hereditary and environmental conditions can lead to aortic dissections, controlling blood pressure can help prevent most aortic dissections. […] High blood pressure prevention starts with a healthy diet, active lifestyle and maintaining a healthy weight. It is well known that obesity is a risk factor for high blood pressure. Smoking and alcohol can raise blood pressure as well and should be avoided. And while many people may find it challenging, getting sufficient, good quality sleep is essential. Not getting enough sleep can increase your risk of high blood pressure and other cardiovascular conditions. Preventing high blood pressure starts with knowing your current blood pressure measurements. And, if your pressures are elevated, working with experienced healthcare providers on a plan to get your blood pressure within an acceptable range is the next step.

• #3 Thoracic Aortic Aneurysm & Aortic Dissection | Marfan Foundation

  https://marfan.org/conditions/familial-aortic-aneurysm/

  Early detection, frequent imaging, and treatment are critical because both aortic aneurysms and dissections increase the risk that the aorta will suddenly burst (rupture), causing massive internal bleeding. Without surgery to prevent aortic rupture, these blood vessel abnormalities can be life-threatening. […] The management of familial thoracic aortic aneurysm and/or dissection requires the coordinated input from a multidisciplinary team of specialists familiar with this condition, including a medical geneticist, cardiologist, and cardiovascular surgeon. […] Medications (drugs) that reduce the stress on the aorta can be helpful. Beta-blockers help lower blood pressure and reduce the force of the heartbeat. They also may help prevent or slow aortic enlargement and reduce the risk of aortic dissection.

• #3 Concomitant pulmonary embolism and aortic dissection: An approach to anticoagulation | Revista Portuguesa de Cardiologia (English edition)

  https://revportcardiol.org/en-concomitant-pulmonary-embolism-aortic-dissection-articulo-S217420492030249X

  Aortic dissection (AD) has been viewed as a contraindication to the use of anticoagulants, due to the high risk of bleeding in the event of aortic rupture or an urgent/emergent need for surgery. However, given the described state of hypercoagulability associated with this condition and the recommendation for rest, the risk of thrombotic phenomena in these patients cannot be ignored. Specific circumstances may lead to a need to use therapeutic anticoagulation; in these cases an assessment of the risk-benefit profile is essential and treatment decisions must be patient-tailored. […] The use of anticoagulation therapy in our patient was permitted after multidisciplinary discussion, given that this conduct in patients with AD is rarely described. […] It has been described that patients with AD present a state of hypercoagulability in an acute phase, resulting in a high risk of venous thromboembolism. However, anticoagulation therapy may also cause the dissection to worsen, resulting in the recanalization of the false lumen and re-dissection, leading to the possible indication of stent grafting, depending on anatomical location.

• #3 The Best Practice for Type B Aortic Dissection – Endovascular Today

  https://evtoday.com/articles/2012-nov-supplement/the-best-practice-for-type-b-aortic-dissection

  Although general consensus exists regarding the need of immediate surgical repair for patients with acute ascending aortic dissection (type A dissection), the optimal treatment of type B dissection is still a matter of debate. […] It has been generally recommended that patients who have type B aortic dissection without complications are treated with medical therapy in an intensive care unit. […] Usually, with aggressive antihypertensive therapy, up to 85% of patients may survive their initial hospital stay. […] In addition, keeping the heart rate below 60 bpm significantly decreases secondary adverse events (aortic expansion, recurrent aortic dissection, aortic rupture) compared to a conventional rate of 60 bpm. […] The advent of endovascular treatment of the thoracic aorta has revolutionized the clinical approach to type B aortic dissection, representing a new minimally invasive alternative to traditional surgery for the management of acute thoracic aortic pathologies, even in high-risk patients who could not be considered operative candidates.

• #3 Aortic Dissection Medical & Patient Charity – UK and Ireland

  https://aorticdissectioncharitabletrust.org/

  For some patients with aortic dissection, there is a hereditary cause. Relatives of such patients should be screened to ensure that they are not at risk. […] We work with those who are responsible for healthcare policy in the UK & Ireland to ensure that there is consistency in the provision of diagnosis for acute aortic dissection, specialised follow-up for survivors and access to clinical genetics for relatives. […] We fund and promote medical research into the detection, prevention and treatment of aortic dissection.

• #3 Lowering blood pressure crucial for preventing aortic dissection | UCLA Health

  https://www.uclahealth.org/news/article/lowering-blood-pressure-crucial-preventing-aortic-dissection

  Getting blood pressure under control is an important part of prevention, as this reduces stress on the aorta. […] Reaching and maintaining a healthy weight, eating a healthful diet and getting regular exercise are also beneficial. […] Someone who has had an aortic dissection should remain under the care of a cardiologist. The doctor will oversee any medications that have been prescribed, and if surgical repairs have been done, will regularly monitor their status.

• #3 The Best Practice for Type B Aortic Dissection – Endovascular Today

  https://evtoday.com/articles/2012-nov-supplement/the-best-practice-for-type-b-aortic-dissection

  Encouraging initial reports of clinical outcomes achieved by endovascular repair and stent graft implantation to treat type B aortic dissection have also accelerated the adoption of TEVAR. […] Endovascular treatment is advocated when a patient with acute type B aortic dissection presents with signs of aortic rupture at imaging and clinical evaluation shows evidence of severely impaired visceral/ peripheral perfusion or symptoms of clinical instability, such as uncontrolled hypertension, severe hypotension, and recurrent or refractory pain. […] TEVAR provided better outcomes, with 9.3% mortality in patients treated with a stent graft and 33.9% mortality in patients who underwent open surgery. […] On the basis of several reports showing improved survival rates, endovascular repair is becoming the standard treatment for patients with acute complicated type B dissection.

• #3 Research | The Aortic Dissection Charitable Trust

  https://aorticdissectioncharitabletrust.org/category/research/

  The Aortic Dissection Charitable Trust funds research to improve detection, prevention, and treatment of aortic dissection, driving breakthroughs for patients and medicine. […] These research grants fund innovative projects dedicated to advancing aortic dissection diagnosis and enhancing patient care for better outcomes. […] Our dedicated supporters have come together to raise vital funds for aortic dissection research, advancing life-saving diagnosis and treatment efforts. […] The DAShED2 study aims to improve the diagnosis of aortic dissection in emergency departments across the UK. By targeting intermediate-risk patients, the study seeks to enhance diagnostic accuracy and CT utilisation. […] The ASES Study represents a significant breakthrough in aortic dissection diagnosis. Supported by NIHR, it aims to enhance emergency department diagnostics, potentially saving lives. […] The DAShED study provides critical insights into the diagnosis of Acute Aortic Syndrome in emergency departments, presenting essential data that significantly improve diagnostic precision in emergency medicine.

• #3 The Best Practice for Type B Aortic Dissection – Endovascular Today

  https://evtoday.com/articles/2012-nov-supplement/the-best-practice-for-type-b-aortic-dissection

  However, aortic remodeling seems to be less effective in chronic dissection with a dilated false lumen, with late aneurysmal degeneration of the thrombosed false lumen reported in 7.8% of cases, suggesting the need for earlier treatment before aortic dilation may occur. […] The INSTEAD study at 2 years does confirm the effectiveness of endovascular therapy for false lumen thrombosis (achieved in 90% of cases) and strengthens the role of a tight blood pressure control and close surveillance. […] According to this approach, all patients who do not respond to medical treatment showing progressive false lumen expansion could be treated with a stent graft because even deferred endovascular therapy is feasible.

• #4 Acute aortic dissection

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-12/Acute-aortic-dissection

  Oral beta-blocker: All patients should receive lifelong therapy with an oral beta-blocker to reduce a) systemic blood pressure and b) the rate of rise in systolic pressure. Both effects of will minimise aortic wall stress. […] Avoid strenuous physical activity […] Thoracic magnetic resonance: A baseline thoracic magnetic resonance scan before discharge, with serial follow-up examinations at three, six and 12 months, even if the patient remains asymptomatic, is recommended.

• #4 Thoracic Aortic Aneurysm & Aortic Dissection | Marfan Foundation

  https://marfan.org/conditions/familial-aortic-aneurysm/

  People with familial thoracic aortic aneurysm and dissection must have routine tests to monitor their aortic health and identify problems before there is an emergency. […] Surgery is most effective if it is done before an aortic dissection or other life-threatening situation. Surgery is considered when: The rate of enlargement of the ascending aorta approaches 0.5 cm per year; The diameter of the ascending aorta is between 4.2 and 5.0 cm (depending on the underlying mutation or family history). […] Regardless of which type of surgery is performed, patients must continue to take their blood pressure medicine and have their aorta monitored at least once a year to safeguard against additional enlargements or tears in other parts of the aorta.

• #4 Concomitant pulmonary embolism and aortic dissection: An approach to anticoagulation | Revista Portuguesa de Cardiologia (English edition)

  https://revportcardiol.org/en-concomitant-pulmonary-embolism-aortic-dissection-articulo-S217420492030249X

  In the authors opinion, the way anticoagulation is managed in an initial phase should include the use of rapid reversal parenteral anticoagulants, such as UFH, due to the possibility of severe bleeding and need for emergent surgery. In a subsequent phase, when considering long-term oral anticoagulation, vitamin K antagonists are a safer choice due to their relatively rapid reversal and support with blood products. However, when considering novel oral anticoagulants, the use of antidotes that reverse their effects almost immediately must also be taken into account. […] The authors recommend that in the case of an uncomplicated Stanford type B AD diagnosis, in which anticoagulant therapy is required due to another concomitant disease, a CTA should be performed in the first 24 hours, before hospital discharge and every three months for the first year, or whenever the patient’s clinical status changes or laboratory analyses are suggestive of acute bleeding or progression of the dissection. From then onwards, follow-up imaging should be performed annually.

• #4 Heart Attack vs Aortic Dissection Symptoms

  https://blog.uvahealth.com/2024/04/30/heart-attack-aortic-dissection-symptoms/

  Finding out if you’re at risk for aortic dissection could save your life. First, if you know, you can take steps to prevent it. But if you do have symptoms, you can alert first responders to your risk. […] If you have risk factors, you’ll want to see a heart doctor who specializes in aortic disease. They can do aortic imaging to measure the size of your aorta. This way, they can find aortic disease even if you don’t have symptoms. […] It’s also really important to control high blood pressure with medication. […] And because aortic disease can run in families, you’ll want to consider genetic counseling.

• #4 Aortic Dissection: Symptoms, Prevention & Treatment – Victor Chang Cardiac Research Institute

  https://www.victorchang.edu.au/heart-disease/aortic-dissection

  Reducing the risk of aortic dissection may include: […] effective management of blood pressure and/or diabetes […] regular checkups if you have aortic aneurysm or family history of aortic dissection […] eating a healthy diet […] quitting smoking […] exercising regularly.

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