[Acute visceral ischaemia, early complication of the aortic syndrome: how to detect and manage it?]

Abstract

Visceral malperfusion as a complication of aortic dissection represent 20 % of all type A or B aortic dissections. Visceral ischaemia is a factor of poor prognosis resulting in a higher mortality for these patients, yet, its clinical diagnosis is often underestimated. In all cases, the cross-sectional imaging, especially computed tomography, is needed to precise the mechanism of ischaemia. It allows differentiating dynamic from static ischaemia and thus to adapt its management. Endovascular treatment of ischaemia has been developed because it allows to a rapid treatment with a high success and low complication rates. Early results of aortic stentgrafting and aortic fenestration are up to 96 %, but late changes on the morphology or function reperfused gut was not studied.