2014 ESC Guidelines on the diagnosis and treatment of aortic diseases

Abstract

3D : three-dimensional AAA : abdominal aortic aneurysm AAS : acute aortic syndrome ACC : American College of Cardiology ACE : angiotensin-converting enzyme AD : Aortic dissection ADAM : Aneurysm Detection and Management AHA : American Heart Association AJAX : Amsterdam Acute Aneurysm AO : aorta AOS : aneurysms-osteoarthritis syndrome ARCH : Aortic Arch Related Cerebral Hazard ATS : arterial tortuosity syndrome BAV : bicuspid aortic valve BSA : body surface area CI : confidence interval CoA : coarctation of the aorta CPG : Committee for Practice Guidelines CSF : cerebrospinal fluid CT : computed tomography DREAM : Dutch Randomized Aneurysm Management DUS : Doppler ultrasound EBCT : electron beam computed tomography ECG : electrocardiogram EDS : Ehlers-Danlos syndrome EDSIV : Ehlers-Danlos syndrome type IV ESC : European Society of Cardiology ESH : European Society of Hypertension EVAR : endovascular aortic repair FDG : 18F-fluorodeoxyglucose FL : false lumen GCA : giant cell arteritis GERAADA : German Registry for Acute Aortic Dissection Type A IAD : iatrogenic aortic dissection IMH : intramural haematoma INSTEAD : Investigation of Stent Grafts in Patients with type B Aortic Dissection IRAD : International Registry of Aortic Dissection IVUS : intravascular ultrasound LCC : left coronary cusp LDS : Loeys-Dietz syndrome MASS : Multicentre Aneurysm Screening Study MESA : Multi-Ethnic Study of Atherosclerosis MPR : multiplanar reconstruction MRA : magnetic resonance angiography MRI : magnetic resonance imaging MSCT : multislice computed tomography NA : not applicable NCC : non-coronary cusp ns-TAAD : non-syndromic thoracic aortic aneurysms and dissection OR : odds ratio OVER : Open Versus Endovascular Repair OxVasc : Oxford Vascular study PARTNER : Placement of AoRtic TraNscathetER Valves PAU : penetrating aortic ulcer PICSS : Patent Foramen Ovale in Cryptogenic Stroke study PET : positron emission tomography RCCA : right common carotid artery RCC : right coronary cusp RCT : randomized, clinical trial RR : relative risk SIRS : systemic inflammatory response SMC : smooth muscle cell TAA : thoracic aortic aneurysm TAAD : thoracic aortic aneurysms and dissection TAI : traumatic aortic injury TEVAR : thoracic endovascular aortic repair TGF : transforming growth factor TI : separate thyroid artery (A. thyroidea) TL : true lumen TOE : transoesophageal echocardiography TS : Turner Syndrome TTE : transthoracic echocardiography UKSAT : UK Small Aneurysm Trial ULP : ulcer-like projection WARSS : Warfarin-Aspirin Recurrent Stroke Study Guidelines summarize and evaluate all available evidence at the time of the writing process, on a particular issue with the aim of assisting health professionals in selecting the best management strategies for an individual patient, with a given condition, taking into account the impact on outcome, as well as the risk-benefit-ratio of particular diagnostic or therapeutic means. Guidelines and recommendations should help the health professionals to make decisions in their daily practice. However, the final decisions concerning an individual patient must be made by the responsible health professional(s) in consultation with the patient and caregiver as appropriate. A great number of Guidelines have been issued in recent years by the European Society of Cardiology (ESC) as well as by other societies and organisations. Because of the impact on clinical practice, quality criteria for the development of guidelines have been established in order to make all decisions …