İntramural Hematom
Özet
Akut intramural hematom akut aortik sendromlar içinde yer alan bir antitedir. Hayatı tehdit edici durum olması nedeni ile hızlı tanı ve tedavi çok önemlidir. Anamnez, fizik muayene, klinik ve laboratuvar verilerinin yanı sıra tanı büyük oranda görüntüleme yöntemleri sayesinde konur. Hematomun anatomik lokalizasyonuna , hastanın hemodinamik durumuna ve hedef organ perfüzyon bozukluğu varlığına göre tedavi kararı verilir.
Acute intramural haematoma is an entity included in the acute aortic syndromes. Rapid diagnosis and treatment are very important as this is a life-threatening condition. In addition to history, physical examination, clinical and laboratory data, the diagnosis is largely based on imaging modalities. Treatment decisions are made according to the anatomical location of the haematoma, the haemodynamic status of the patient and the presence of target organ perfusion abnormalities.
Referanslar
Oderich GS, Kärkkäinen JM, Reed NR, et al. Penetrating Aortic Ulcer and Intramural Hematoma. Cardiovasc Intervent Radiol. 2019 Mar;42(3):321-334. doi: 10.1007/s00270-018-2114-x.
Chen YY, Yen HT, Lo CM, et al. Natural courses and long-term results of type A acute aortic intramural haematoma and retrograde thrombosed type A acute aortic dissection: a single-centre experience. Interact Cardiovasc Thorac Surg 2020; 30:113–120.
Brown JA, Arnaoutakis GJ, Kilic A, et al. Current trends in the management of acute type A aortic intramural hematoma. J Card Surg 2020; 35:2331–2337.
Krukenberg E. Contribution to the question of dissecting aneurysm. Beitr Pathol Anat Allg Pathol. 1920;67:329–51.
Harris KM, Braverman AC, Eagle KA, et al. Acute aortic intramural hematoma. Circulation. 2012;126(11supp11):591–6.
Park KH, Lim C, Choi JH, et al. Prevalence of aortic intimal defect in surgically treated acute Type A intramural hematoma. Ann Thorac Surg. 2008;86(5):1494–500.
Chao CP, Walker TG, Kalva SP. Natural history and CT appearances of aortic intramural hematoma. Radiographics. 2009;29(3):791–804.
Evangelista A, Mukherjee D, Mehta RH, et al. Acute intramural hematoma of the aorta: a mystery in evolution. Circulation. 2005;111(8):1063–70.
Evangelista A, Maldonado G, Moral S, et al. Intramural hematoma and penetrating ulcer in the descending aorta: differences and similarities.Ann Cardiothorac Surg.2019;8(4):456-470.
Maslow A, Atalay MK, Sodha N. Intramural hematoma. J Cardiothorac Vasc Anesth.2018;32(3):1341-1362.
Tolenaar JL, Harris KM, Upchurch GR Jr, et al. The differences and similarities between intramural hematoma of the descending aorta and acute Type B dissection. J Vasc Surg. 2013;58(6):1498–504.
Ganaha F, Miller DC, Sugimoto K, et al. Prognosis of aortic intramural hematoma with and without penetrating atherosclerotic ulcer: a clinical and radiological analysis. Circulation. 2002;106(3):342–8.
Spanos K, Ko¨lbel T. Treatment of intramural haematoma of the ascending aorta (Type A) should be selective. Eur J Vasc Endovasc Surg 2021; 62:7–8.
Song JK, Yim JH, Ahn JM, et al. Outcomes of patients with acute Type A aortic intramural hematoma. Circulation. 2009;120(21):2046–52.
von Kodolitsch Y, Csosz SK, Koschyk DH, et al. Intramural hematoma of the aorta: predictors of progression to dissection and rupture. Circulation. 2003;107(8):1158–63.
Evangelista A, Dominguez R, Sebastia C, et al. Prognostic value of clinical and morphologic findings in short-term evolution of aortic intramural haematoma. Therapeutic implications. Eur Heart J. 2004;25(1):81–7.
Sundt TM. Intramural hematoma and penetrating aortic ulcer. Curr Opin Cardiol. 2007;22(6):504–9.
Choi SH, Choi SJ, Kim JH, et al. Useful CT findings for predicting the progression of aortic intramural hematoma to overt aortic dissection. J Comput Assist Tomogr. 2001;25(2):295–9.
Hiratzka LF, Bakris GL, Beckman JA, et al. 2010 CCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the diagnosis and management of patients with thoracic aortic disease. A Report of the American College of Cardiology Foundation/ American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology,American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons,and Society for Vascular Medicine. J Am Coll Cardiol. 2010;55(14):e27–e129. doi:10.1016/j.jacc.2010.02.015
Erbel R, Aboyans V, Boileau C, et al. ESC Committee for Practice Guidelines. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J. 2014;35(41):2873–2926. doi:10.1093/eurheartj/ehu281
Wooley CF, Sparks EH, Boudoulas H. Aortic pain. Prog Cardiovasc Dis. 1998;40(6):563–589. doi:10.1016/S0033-0620(98)80004-2
Klompas M. Does this patient have an acute thoracic aortic dissection? JAMA. 2002;287(17):2262–2272. doi:10.1001/jama.287.17.2262
Morentin Campillo B, Molina Aguilar P, Monzó Blasco A, et al. Sudden death due to thoracic aortic dissection in young people: a multicenter forensic study. Rev Esp Cardiol. 2019;72(7):553–561. doi:10.1016/j.recesp.2018.05.036
Vilacosta I, Aragoncillo P, Cañadas V, et al. Acute aortic syndrome: a new look at an old conundrum. Heart. 2009;95(14):1130–1139. doi:10.1136/hrt.2008.153650
Tsai TT, Nienaber CA, Eagle KA. Acute aortic syndromes. Circulation. 2005;112(24):3802–13.
Rogers AM, Hermann LK, Booher AM, et al. Sensitivity of the aortic dissection detection risk score, a novel guideline-based tool for identification of acute aortic dissection at initial presentation: results from the international registry of acute aortic dissection. Circulation. 2011;123(20):2213–2218. doi:10.1161/CIRCULATION AHA.110.988568
Gorla R, Erbel R, Kahlert P, et al. Diagnostic role and prognostic implications of D-dimer in different classes of acute aortic syndromes. Eur Heart J Acute Cardiovasc Care. 2017;6 (5):379–388. doi:10.1177/2048872615594500
Nazerian P, Mueller C, Soeiro AM, et al. Diagnostic accuracy of the aortic dissection detection risk score plus d-Dimer for acute aortic syndromes: the advised prospective multicenter study. Circulation. 2018;137(3):250–258. doi:10.1161/CIRCULATIONAHA.117.029 457
Gorla R, Erbel R, Kahlert P, et al. Accuracy of a diagnostic strategy combining aortic dissection detection risk score and D-dimer levels in patients with suspected acute aortic syndrome. Eur Heart J Acute Cardiovasc Care. 2017;6(5):371–378. doi:10.1177/2048872615594497
Ferrera C, Vilacosta I, Suárez-Barrientos A, et al. Aortic intramural hematoma. All-in-one complications. Int J Cardiol. 2013;167(4):e97–8. doi:10.1016/j.ijcard.2013.03.155
Suzuki T, Distante A, Zizza A, et al. Diagnosis of acute aortic dissection by D-dimer: The International Registry of Acute Aortic Dissection Substudy on Biomarkers (IRAD-Bio) experience. Circulation. 2009;119 (20):2702–2707. doi:10.1161/CIRCULATIONAHA.108.833004
Chenkin J, Atzema CL. Contemporary application of point-of-care echocardiography in the emergency department. Can J Cardiol.2018;34(2):109–116. doi:10.1016/j.cjca.2017.08.018
Evangelista A, Flachskampf FA, Erbel R, et al. Echocardiography in aortic diseases: EAE recommendations for clinical practice. Eur J Echocardiogr. 2010;11:645–658. doi:10.1093/ejechocard/jeq056
Evangelista A, Maldonado G, Gruosso D, et al. The current role of echocardiography in acute aortic syndrome. Echo Res Pract. 2019;6(2):R53–R63. doi:10.1530/ERP-18-0058
Keren A, Kim CB, Hu BS, et al. Accuracy of biplane and multiplane transesophageal echocardiography in diagnosis of typical acute aortic dissection and intramural hematoma. J Am Coll Cardiol. 1996;28 (3):627–636. doi:10.1016/0735-1097(96)00186-6
Janosi RA, Gorla R, Tsagakis K, et al. Thoracic endovascular repair of complicated penetrating aortic ulcer: an 11-year single-center experience. J Endovasc Ther. 2016;23(1):150–9.
Mussa FF, Horton JD, Moridzadeh R, et al. Acute aortic dissection and intramural hematoma: a systematic review. JAMA. 2016;316(7):754–763. doi:10.1001/jama.2016.10026
Evangelista A, Carro A, Moral S, et al. Imaging modalities for the early diagnosis of acute aortic syndrome. Nat Rev Cardiol. 2013;10(8):477–86.
Ciccone MM, Dentamaro I, Masi F, et al. Advances in the diagnosis of acute aortic syndromes: role of imaging techniques. Vasc Med. 2016;21(3):239–50.
Nienaber CA. The role of imaging in acute aortic syndromes. Eur Heart J Cardiovasc Imaging. 2013;14(1):15–23.
Akin I, Kische S, Ince H, et al. Penetrating aortic ulcer, intramural hematoma, acute aortic syndrome: when to do what. J Cardiovasc Surg (Torino). 2012;53(1 Suppl 1):83–90.
Carpenter SW, Kodolitsch YV, Debus ES, et al. Acute aortic syndromes: definition, prognosis and treatment options. J Cardiovasc Surg. 2014;55(2 Suppl 1):133–44.
Kaji S, Akasaka T, Horibata Y, et al. Long-term prognosis of patients with Type A aortic intramural hematoma. Circulation. 2002;106(12 Suppl 1):I248–52.
Referanslar
Oderich GS, Kärkkäinen JM, Reed NR, et al. Penetrating Aortic Ulcer and Intramural Hematoma. Cardiovasc Intervent Radiol. 2019 Mar;42(3):321-334. doi: 10.1007/s00270-018-2114-x.
Chen YY, Yen HT, Lo CM, et al. Natural courses and long-term results of type A acute aortic intramural haematoma and retrograde thrombosed type A acute aortic dissection: a single-centre experience. Interact Cardiovasc Thorac Surg 2020; 30:113–120.
Brown JA, Arnaoutakis GJ, Kilic A, et al. Current trends in the management of acute type A aortic intramural hematoma. J Card Surg 2020; 35:2331–2337.
Krukenberg E. Contribution to the question of dissecting aneurysm. Beitr Pathol Anat Allg Pathol. 1920;67:329–51.
Harris KM, Braverman AC, Eagle KA, et al. Acute aortic intramural hematoma. Circulation. 2012;126(11supp11):591–6.
Park KH, Lim C, Choi JH, et al. Prevalence of aortic intimal defect in surgically treated acute Type A intramural hematoma. Ann Thorac Surg. 2008;86(5):1494–500.
Chao CP, Walker TG, Kalva SP. Natural history and CT appearances of aortic intramural hematoma. Radiographics. 2009;29(3):791–804.
Evangelista A, Mukherjee D, Mehta RH, et al. Acute intramural hematoma of the aorta: a mystery in evolution. Circulation. 2005;111(8):1063–70.
Evangelista A, Maldonado G, Moral S, et al. Intramural hematoma and penetrating ulcer in the descending aorta: differences and similarities.Ann Cardiothorac Surg.2019;8(4):456-470.
Maslow A, Atalay MK, Sodha N. Intramural hematoma. J Cardiothorac Vasc Anesth.2018;32(3):1341-1362.
Tolenaar JL, Harris KM, Upchurch GR Jr, et al. The differences and similarities between intramural hematoma of the descending aorta and acute Type B dissection. J Vasc Surg. 2013;58(6):1498–504.
Ganaha F, Miller DC, Sugimoto K, et al. Prognosis of aortic intramural hematoma with and without penetrating atherosclerotic ulcer: a clinical and radiological analysis. Circulation. 2002;106(3):342–8.
Spanos K, Ko¨lbel T. Treatment of intramural haematoma of the ascending aorta (Type A) should be selective. Eur J Vasc Endovasc Surg 2021; 62:7–8.
Song JK, Yim JH, Ahn JM, et al. Outcomes of patients with acute Type A aortic intramural hematoma. Circulation. 2009;120(21):2046–52.
von Kodolitsch Y, Csosz SK, Koschyk DH, et al. Intramural hematoma of the aorta: predictors of progression to dissection and rupture. Circulation. 2003;107(8):1158–63.
Evangelista A, Dominguez R, Sebastia C, et al. Prognostic value of clinical and morphologic findings in short-term evolution of aortic intramural haematoma. Therapeutic implications. Eur Heart J. 2004;25(1):81–7.
Sundt TM. Intramural hematoma and penetrating aortic ulcer. Curr Opin Cardiol. 2007;22(6):504–9.
Choi SH, Choi SJ, Kim JH, et al. Useful CT findings for predicting the progression of aortic intramural hematoma to overt aortic dissection. J Comput Assist Tomogr. 2001;25(2):295–9.
Hiratzka LF, Bakris GL, Beckman JA, et al. 2010 CCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the diagnosis and management of patients with thoracic aortic disease. A Report of the American College of Cardiology Foundation/ American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology,American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons,and Society for Vascular Medicine. J Am Coll Cardiol. 2010;55(14):e27–e129. doi:10.1016/j.jacc.2010.02.015
Erbel R, Aboyans V, Boileau C, et al. ESC Committee for Practice Guidelines. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J. 2014;35(41):2873–2926. doi:10.1093/eurheartj/ehu281
Wooley CF, Sparks EH, Boudoulas H. Aortic pain. Prog Cardiovasc Dis. 1998;40(6):563–589. doi:10.1016/S0033-0620(98)80004-2
Klompas M. Does this patient have an acute thoracic aortic dissection? JAMA. 2002;287(17):2262–2272. doi:10.1001/jama.287.17.2262
Morentin Campillo B, Molina Aguilar P, Monzó Blasco A, et al. Sudden death due to thoracic aortic dissection in young people: a multicenter forensic study. Rev Esp Cardiol. 2019;72(7):553–561. doi:10.1016/j.recesp.2018.05.036
Vilacosta I, Aragoncillo P, Cañadas V, et al. Acute aortic syndrome: a new look at an old conundrum. Heart. 2009;95(14):1130–1139. doi:10.1136/hrt.2008.153650
Tsai TT, Nienaber CA, Eagle KA. Acute aortic syndromes. Circulation. 2005;112(24):3802–13.
Rogers AM, Hermann LK, Booher AM, et al. Sensitivity of the aortic dissection detection risk score, a novel guideline-based tool for identification of acute aortic dissection at initial presentation: results from the international registry of acute aortic dissection. Circulation. 2011;123(20):2213–2218. doi:10.1161/CIRCULATION AHA.110.988568
Gorla R, Erbel R, Kahlert P, et al. Diagnostic role and prognostic implications of D-dimer in different classes of acute aortic syndromes. Eur Heart J Acute Cardiovasc Care. 2017;6 (5):379–388. doi:10.1177/2048872615594500
Nazerian P, Mueller C, Soeiro AM, et al. Diagnostic accuracy of the aortic dissection detection risk score plus d-Dimer for acute aortic syndromes: the advised prospective multicenter study. Circulation. 2018;137(3):250–258. doi:10.1161/CIRCULATIONAHA.117.029 457
Gorla R, Erbel R, Kahlert P, et al. Accuracy of a diagnostic strategy combining aortic dissection detection risk score and D-dimer levels in patients with suspected acute aortic syndrome. Eur Heart J Acute Cardiovasc Care. 2017;6(5):371–378. doi:10.1177/2048872615594497
Ferrera C, Vilacosta I, Suárez-Barrientos A, et al. Aortic intramural hematoma. All-in-one complications. Int J Cardiol. 2013;167(4):e97–8. doi:10.1016/j.ijcard.2013.03.155
Suzuki T, Distante A, Zizza A, et al. Diagnosis of acute aortic dissection by D-dimer: The International Registry of Acute Aortic Dissection Substudy on Biomarkers (IRAD-Bio) experience. Circulation. 2009;119 (20):2702–2707. doi:10.1161/CIRCULATIONAHA.108.833004
Chenkin J, Atzema CL. Contemporary application of point-of-care echocardiography in the emergency department. Can J Cardiol.2018;34(2):109–116. doi:10.1016/j.cjca.2017.08.018
Evangelista A, Flachskampf FA, Erbel R, et al. Echocardiography in aortic diseases: EAE recommendations for clinical practice. Eur J Echocardiogr. 2010;11:645–658. doi:10.1093/ejechocard/jeq056
Evangelista A, Maldonado G, Gruosso D, et al. The current role of echocardiography in acute aortic syndrome. Echo Res Pract. 2019;6(2):R53–R63. doi:10.1530/ERP-18-0058
Keren A, Kim CB, Hu BS, et al. Accuracy of biplane and multiplane transesophageal echocardiography in diagnosis of typical acute aortic dissection and intramural hematoma. J Am Coll Cardiol. 1996;28 (3):627–636. doi:10.1016/0735-1097(96)00186-6
Janosi RA, Gorla R, Tsagakis K, et al. Thoracic endovascular repair of complicated penetrating aortic ulcer: an 11-year single-center experience. J Endovasc Ther. 2016;23(1):150–9.
Mussa FF, Horton JD, Moridzadeh R, et al. Acute aortic dissection and intramural hematoma: a systematic review. JAMA. 2016;316(7):754–763. doi:10.1001/jama.2016.10026
Evangelista A, Carro A, Moral S, et al. Imaging modalities for the early diagnosis of acute aortic syndrome. Nat Rev Cardiol. 2013;10(8):477–86.
Ciccone MM, Dentamaro I, Masi F, et al. Advances in the diagnosis of acute aortic syndromes: role of imaging techniques. Vasc Med. 2016;21(3):239–50.
Nienaber CA. The role of imaging in acute aortic syndromes. Eur Heart J Cardiovasc Imaging. 2013;14(1):15–23.
Akin I, Kische S, Ince H, et al. Penetrating aortic ulcer, intramural hematoma, acute aortic syndrome: when to do what. J Cardiovasc Surg (Torino). 2012;53(1 Suppl 1):83–90.
Carpenter SW, Kodolitsch YV, Debus ES, et al. Acute aortic syndromes: definition, prognosis and treatment options. J Cardiovasc Surg. 2014;55(2 Suppl 1):133–44.
Kaji S, Akasaka T, Horibata Y, et al. Long-term prognosis of patients with Type A aortic intramural hematoma. Circulation. 2002;106(12 Suppl 1):I248–52.
