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Rinaldi et al. Vessel Plus 2024;8:21 Vessel Plus
DOI: 10.20517/2574-1209.2023.65

Review Open Access

Endovascular repair for acute aortic syndrome

involving the descending aorta

Enrico Rinaldi, Daniele Mascia, Carlo Campesi, Alessio Centi Pizzutilli, Germano Melissano
Division of Vascular Surgery, Vita-Salute University, IRCCS San Raffaele Scientific Institute, Milan 20100, Italy.

Correspondence to: Dr. Enrico Rinaldi, Division of Vascular Surgery, Vita-Salute University, IRCCS San Raffaele Scientific
Institute, Milan 20100, Italy. E-mail: rinaldi.enrico@hsr.it

How to cite this article: Rinaldi E, Mascia D, Campesi C, Pizzutilli AC, Melissano G. Endovascular repair for acute aortic
syndrome involving the descending aorta. Vessel Plus 2024;8:21. https://dx.doi.org/10.20517/2574-1209.2023.65

Received: 14 Jun 2023 First Decision: 13 Nov 2023 Revised: 1 Apr 2024 Accepted: 6 May 2024 Published: 13 May 2024

Academic Editors: Carlos A. Mestres, Antonio Calafiore Copy Editor: Fangyuan Liu Production Editor: Fangyuan Liu

Abstract
This review paper delves into the acute aortic syndromes, with a particular focus on those affecting the descending
thoracic aorta, including acute type B aortic dissection (aTBAD), intramural hematoma (IMH), penetrating aortic
ulcer (PAU), blunt traumatic thoracic aortic injury (bTAI), and ruptured aneurysm of the descending thoracic aorta
(rDTA). These conditions present with sudden-onset symptoms such as severe chest or back pain, necessitating
immediate medical attention. While traditional open surgical repair was historically the mainstay of treatment,
advancements in endovascular techniques have revolutionized management approaches. Endovascular treatment
offers advantages such as reduced operative time, blood loss, and hospital stay, making it a safer option for high-
risk patients. However, it is crucial to carefully evaluate patients for endovascular suitability, considering the
potential complications and risks associated with these techniques. This paper aims to provide an updated
overview of acute aortic syndromes involving the descending thoracic aorta, analyze available therapeutic options,
and review contemporary treatment modalities, shedding light on the technical aspects and considerations guiding
clinical decision-making in this complex and life-threatening scenario.

Keywords: Acute aortic syndromes, aortic dissection, intramural hematoma, penetrating aortic ulcers, aortic
trauma, ruptured aortic aneurysms

INTRODUCTION
Acute aortic syndromes (AAS) involving the descending thoracic aorta are potentially life-threatening

© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0
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