Peripheral Vascular Manifestations of Aortic Dissection: Recognition and Management

Abstract

Acute dissection is the most common catastrophic condition of the aorta, yet the diagnosis is often delayed or incorrect. The presentation of this condition may be quite variable because different patterns of aortic branch vessel occlusion may exist. The clinician must be wary of the condition and make a prompt diagnosis through a number of available imaging modalities, including transesophageal echocardiogram, computed tomography, or angio graphy. Although the surgical management of aortic dissection involving the ascending aorta is well accepted, the management of dissection involving the descending aorta is controversial. Optimal management in this case depends upon the branch vessels involved and the general condition of the patient. Newer modalities of management of aortic dissection include endovas cular techniques aimed at dissection flap fenestration and stent placement.