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. 2020 Oct;26(4):2391-2399.
doi: 10.1007/s12253-020-00835-x. Epub 2020 Jun 16.

Ruptured Aortic Aneurysm and Dissection Related Death: an Autopsy Database Analysis

Dániel Pál  1 , Brigitta Szilágyi  2 , Márton Berczeli  1 , Csaba Imre Szalay  3 , Balázs Sárdy  1 , Zoltán Oláh  1 , Tamás Székely  4 , Gergely Rácz  5 , Péter Banga  1 , Zsófia Czinege  1 , Péter Sótonyi  6
Affiliations

Ruptured Aortic Aneurysm and Dissection Related Death: an Autopsy Database Analysis

Dániel Pál et al. Pathol Oncol Res. 2020 Oct.

Abstract

Acute aortic catastrophes (AAC), mainly ruptured aneurysms and dissections, lead all other vascular conditions in morbidity and mortality, even if intervention occurs. The aim of our study was to give a descriptive overview of the demographic and pathological characteristics of AAC. Between 1994 and 2013, 80,469 autopsies were performed at Semmelweis University hospitals in Budapest. After collecting the autopsy reports we were able to create the AAC database upon which we conducted our analysis. We found 567 cases of AAC. The cause of death in 120 of them was classified as a non-ruptured aorta with malperfusion or distal embolization. Of the remaining 447 cases, in 305 the cause of death was a ruptured aortic aneurysm (rAA), and in 142 it was a ruptured aortic dissection (rAD). The distribution of rAA cases was 34.4% thoracal, 4.3% thoracoabdominal, and 61.3% abdominal. We found female dominance where the rAA was thoracal. In rAD cases, 84% were Stanford A and 16% Stanford B type. In both groups we found different pathological distributions. In the prehospital group, the number of thoracal ruptures was considerable. 88% of the patients with Stanford A dissection died in the prehospital or perioperative period. The most progressive AACs were ruptures of intrapericardial aneurysms and Stanford A dissections., however survival rate can be elevated by using rapid imaging examination and immediate surgical intervention. We want to highlight that our study contains such gender differences, which are worth to be taken into consideration.

Keywords: Acute aortic syndrome; Aortic aneurysm; Aortic dissection; Autopsy; Bleeding; Rupture.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Acute aortic catastrophes, 1994-2014, N=567
Fig. 2
Fig. 2
a Age and gender differencies in rAA group, 1994-2014, N=305. b Age and gender differencies in rAD group, 1994-2014, N=142
Fig. 3
Fig. 3
a Gender differencies in rAA localisation, 1994-2014, N=305. b Gender differences in direct of rupture, rAA group, 1994-2014, N=305
See this image and copyright information in PMC

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