Facharzt FMH Radiologie Practice Questions - Facharzt FMH Für Radiologie Spécialiste FMH En Radiologie Exam

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A 72-year-old male with long-standing poorly controlled hypertension presents to the emergency department with sudden-onset, severe, tearing interscapular back pain. Contrast-enhanced CT angiography (CTA) of the chest and abdomen reveals a hyperdense crescentic thickening of the aortic wall on non-contrast CT that does not enhance on contrast-enhanced phases, extending from distal to the origin of the left subclavian artery down to the celiac axis. There is no intimal flap or false lumen flow, and all branch vessels are widely patent. What is the diagnosis and appropriate initial management strategy according to international thoracic aortic guidelines?

Acute Stanford Type A aortic dissection requiring emergent open surgical ascending aortic graft replacement Aortitis secondary to giant cell arteritis requiring immediate high-dose intravenous pulsed methylprednisolone Ruptured thoracic aortic aneurysm requiring immediate hybrid open debranching Acute Stanford Type B aortic intramural hematoma (IMH); initial management is medical therapy with intravenous beta-blockers and strict blood pressure control, reserving TEVAR for complications

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Acute Stanford Type B aortic intramural hematoma (IMH); initial management is medical therapy with intravenous beta-blockers and strict blood pressure control, reserving TEVAR for complications

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