Aortic Diseases Guidelines

Preamble

Introduction

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

Surgery

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

Aortitis

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

Appendix

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

References