Pathogenesis in acute aortic syndromes: Aortic aneurysm leak and rupture and traumatic aortic transection

Diagnostic algorithms in evaluation of aortic emergencies are changing. Catheter angiography has traditionally been the gold standard for evaluating patients with aortic disease. However, currently helical CT plays the dominant and critical role in the evaluation of patients presenting with aortic emergencies. In the evaluation of patients with acute thoracic injuries, helical CT had a sensitivity and negative predictive value equivalent to those of aortography [8]. CT angiography was 100% sensitive and performed better than conventional angiography [9] in the evaluation of aortic aneurysm extent. The advancement in helical CT brings this modality to the forefront of acute aortic imaging as a reliable and noninvasive technique for definitive evaluation of patients with aortic aneurysm and traumatic aortic transection and not just as a screening modality before ordering an aortogram.