Dissecting aneurysms of the aorta: roentgen manifestations including a comparison with other types of aneurysms.

THE RECOGNITION and successful surgical therapy of dissecting aneurysms of the aorta are becoming more common. Long-term survivals of these patients, in many of whom the onset was insidious, have been documented (5). Improved treatment must in part rest first on early and accurate diagnosis by plain radiographs and laminagraphy. Determination of involvement of vital brachiocephalic and visceral vessels is the next consideration. Finally, if possible, the surgeon should be advised of the physiological alterations and flow directions within the diseased and remaining normal segments. Gore (2) distinguishes two microscopic patterns in patients with nonluetic medial disease of the aorta. In the first, medial necrosis is primarily a degenerative process of muscle components and frequently accompanies arteriosclerosis. In the second, medial necrosis involves principally elastic tissue, and this lesion may be associated with other aspects of Marfan's syndrome. Patients with this latter pattern have, in general, ...