Aortic dissection is a life-threatening condition, and correct diagnosis is mandatory for proper management. Only the combination of rapid medical and surgical therapy can improve the prognosis of aortic dissection. Therefore, it is necessary that the diagnosis is established with high accuracy. Different diagnostic methods, including angiography, transoesophageal echocardiography, computed tomography and magnetic resonance imaging have proved useful in the morphologic characterization of this condition are currently used in the management of patients with aortic dissection. Because of increasing experience with these imaging modalities, specific variants of aortic dissection, such as intramural hematoma, can now be diagnosed in vivo. Besides, intravascular ultrasound imaging provides high resolution cross-sectional images of the aortic wall architecture that complement angiographic information. Promising techniques for treatment of aortic disease may lead to a less invasive therapy for selected patients than conventional surgical therapy. Ischemic complications or even neurological manifestations of the oartic dissection either due to extension of the dissection process into a branch artery, or compression of the artery by the false lumen of the dissecting aortic hematoma, can be effectively and safely treated with stent placement and balloon fenestration. The epidemiology, variation in presentation, investigation, and management of aortic dissection are reviewed in this article.
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|Published - 2002