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Aortic disease: using the ESC Guidelines to solve clinical problems
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Aortic Diseases

ESC Clinical Practice Guidelines

Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult.

In addition to coronary and peripheral artery diseases, aortic diseases contribute to the wide spectrum of arterial diseases: aortic aneurysms, acute aortic syndromes (AAS) including aortic dissection (AD), intramural haematoma (IMH), penetrating atherosclerotic ulcer (PAU) and traumatic aortic injury (TAI), pseudoaneurysm, aortic rupture, atherosclerotic and inflammatory affections, as well as genetic diseases (e.g. Marfan syndrome) and congenital abnormalities including the coarctation of the aorta (CoA).

Diseases of the Aorta
Cardiovascular Surgery
Acute Cardiac Care
Guidelines version available to download
Published in2014
ReferenceEur Heart J 2014;35:2873-2926 - Eur Heart J doi:10.1093/eurheartj/ehu281
Published in2015
ReferenceAortic Corrigendum T3
Published in2014
ReferenceESC Guidelines on Aortic Diseases Web Addenda
Published in2014
Reference2014 Take Home Messages & Gaps in Evidence
Published in2014
ReferencePocket Guidelines Abriged version
  • PDA
  • Published in2014
    ReferenceAortic Pocket Guidelines Mobile App
    Published in2014
    Reference56 Slides 2014 Aortic Diseases
    Published in2016
    ReferenceAorta Summary Card Online
    Published in2014
    Reference36 CME Questions
    Published in2001
    ReferenceEur Heart J; 22:1642-1681
    Table of contents: Full Text (ESC Clinical Practice Guidelines)



    The normal and the ageing aorta

    Assessment of the aorta

    1. Clinical examination
    2. Laboratory testing
    3. Imaging
      1. Chest X-ray
      2. Ultrasound
      3. Computed tomography
      4. Positron emission tomography/computed tomography
      5. Magnetic resonance imaging
      6. Aortography
      7. Intravascular ultrasound
    4. Assessment of aortic stiffness

    Treatment options

    1. Principles of medical therapy
    2. Endovascular therapy
      1. Thoracic endovascular aortic repair
      2. Abdominal endovascular aortic repair


    1. Ascending aorta
    2. Aortic arch
    3. Thoracoabdominal aorta
    4. Abdominal aorta

    Acute thoracic aortic syndromes

    1. Definition
    2. Pathology and classification
    3. Acute aortic dissection
      1. Definition and classification
      2. Epidemiology
      3. Clinical presentation and complications
      4. Laboratory testing
      5. Diagnostic imaging in acute aortic dissection
      6. Diagnostic work-up
      7. Treatment
    4. Intramural haematoma
      1. Definition
      2. Diagnosis
      3. Natural history, morphological changes, and complications
      4. Indications for surgery and thoracic endovascular aortic repair
    5. Penetrating aortic ulcer
      1. Definition
      2. Diagnostic imaging
      3. Management
      4. Interventional therapy
    6. Aortic pseudoaneurysm
    7. (Contained) rupture of aortic aneurysm
      1. Contained rupture of thoracic aortic aneurysm
    8. Traumatic aortic injury
      1. Definition, epidemiology and classification
      2. Patient presentation and diagnosis
      3. Indications for treatment in traumatic aortic injury
      4. Medical therapy in traumatic aortic injury
      5. Surgery in traumatic aortic injury
      6. Endovascular therapy in traumatic aortic injury
      7. Long-term surveillance in traumatic aortic injury
    9. Iatrogenic aortic dissection

    Aortic aneurysms

    1. Thoracic aortic aneurysms
    2. Abdominal aortic aneurysm
      1. Definition
      2. Risk factors
      3. Natural history
      4. Diagnosis
      5. Abdominal aortic aneurysm repair
      6. Long-term prognosis and follow-up of aortic aneurysm repair

    Genetic diseases affecting the aorta

    1. Chromosomal and inherited syndromic thoracic aortic aneurysms and dissection
    2. Aortic diseases associated with bicuspid aortic valve
    3. Coarctation of the aorta

    Atherosclerotic lesions of the aorta

    1. Thromboembolic aortic disease
    2. Mobile aortic thrombosis
    3. Atherosclerotic aortic occlusion
    4. Calcified aorta
    5. Coral reef aorta


    1. Definition, types, and diagnosis
    2. Treatment

    Aortic tumours

    1. Primary malignant tumours of the aorta

    Long-term follow-up of aortic diseases

    1. Chronic aortic dissection
    2. Follow-up after thoracic aortic intervention
    3. Follow-up of patients after intervention for abdominal aortic aneurysm

    Gaps in evidence


    Web addenda – All web figures and web tables are available in the online addenda





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