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PubMedDate not supplied

MR imaging of age-related dimensional changes of thoracic aorta.

Changes in the dimensions of the thoracic aorta with age were studied in 70 healthy volunteers between the ages of 10 and 83 years. Spin echo images were acquired at end-diastole in three oblique planes through the ascending aorta, aortic arch, and descending aorta. A double oblique image through the whole of the thoracic aorta was also acquired. Measurements of aortic cross-sectional area and length were corrected for body surface area, and normal magnetic resonance standards were established. The direct correlation that aortic dimensions have with age is likely to be due to loss of elasticity. The ratio between areas of the ascending aorta and the aortic arch is directly related to age whereas the ratio between the aortic arch and the descending aorta is inversely related to age.

Adolescent↗
PubMed1997

Atheromatous disease of the thoracic aorta: pathologic and clinical implications.

PURPOSE: To review recent developments in the diagnosis, clinical epidemiology, pathology, and management of atherosclerosis of the thoracic aorta, especially atherosclerosis of the thoracic aorta as a source of embolization. DATA SOURCES: MEDLINE searches, bibliographies of published papers, and consultation with experts in the field. STUDY SELECTION: English-language publications on atherosclerosis of the thoracic aorta were selected. DATA SYNTHESIS: During the last 6 years, the increasing use of transesophageal echocardiography has shown that atherosclerotic plaque in the thoracic aorta is a source of otherwise unexplained embolic events, including stroke, transient ischemic attack, and peripheral emboli. Retrospective studies have documented a strong independent association between larger lesions (4 mm to 5 mm) and previous embolic disease, and prospective studies have shown that patients with these lesions have a high risk for future events (in one study, the risk for stroke was 12%; in another, the risk for cerebral or peripheral events was 33% in a follow-up period of just 14 months). These lesions also pose a serious risk for embolization caused by manipulation of the aorta during catheterization, intra-aortic balloon-pump placement, and cannulation of the aorta for heart surgery. Pathologic examination has shown atherosclerotic plaque, often with superimposed thrombi that account for the mobile components seen on transesophageal echocardiography. The management of patients who have atherosclerotic lesions in the thoracic aorta has not been determined prospectively. However, anticoagulation may help prevent emboli, as it does for patients who have thrombi in other locations, such as the left atrium and the left ventricle. CONCLUSIONS: Protruding atherosclerotic lesions in the thoracic aorta, often with superimposed mobile thrombi, are an important cause of embolic disease. Transesophageal echocardiography should be considered in the work-up of patients who have unexplained embolic events.

Aorta, Thoracic↗
PubMed2000

[Penetrating atherosclerotic ulcer of the thoracic aorta descendens]

Penetrating atherosclerotic ulcer of the thoracic aorta descendens. HISTORY AND CLINICAL FINDINGS: A 75-year-old man with a history of generalised atherosclerosis was admitted to hospital for invasive assessment of progredient typical angina pectoris. Apart from diminished peripheral pulses, physical examination was normal. INVESTIGATIONS: Coronary angiography revealed a three vessel coronary artery disease. The chest X-ray showed elongation and dilatation of the distal aortic arch and the proximal descending aorta thoracalis. Computed tomography and magnetic resonance imaging of the thorax as well as magnetic resonance angiography of the thoracic aorta, demonstrated a penetrating atherosclerotic ulcer of the descending aorta thoracalis, with extensive intramural hematoma. TREATMENT AND COURSE: After percutaneous ballon-dilatation of the right coronary artery and the circumflex artery, the patient was asymptomatic. Considering all aspects of the patients condition, medical treatment of the penetrating atherosclerotic ulcer was decided for the patient. The findings of the thoracic computed tomography after 6 months were unchanged. CONCLUSION: The penetrating atherosclerotic ulcer of the thoracic aorta is a less known clinical entity. Our case report demonstrates that even extensive forms can be clinical asymptomatic and discovered by routine radiologic examinations.

Journal Article↗