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Enfermedad Vascular Extratorácica Difusa en Aneurisma y Disección Aórtica Torácica No Sindrómica

Luke Dreher¹, Hussein Abdul Nabi¹, Hend Bcharah¹

¹Department of Cardiovascular Medicine, Mayo Clinic Arizona, USA.

The American journal of cardiology

|February 27, 2026

Resumen

Los aneurismas y disecciones extratorácicos son comunes en pacientes con aneurisma y disección aórtica torácica no sindrómica (nsTAAD), y aumentan con la edad. Esto resalta la necesidad de una evaluación vascular integral y el manejo de los factores de riesgo en esta población.

Área de la Ciencia:

Medicina Cardiovascular
Cirugía Vascular
Radiología

Sus antecedentes:

El aneurisma y la disección aórtica torácica no sindrómica (nsTAAD) pueden afectar a las arterias sistémicas, pero los patrones de enfermedad extratorácica no están claros.
Comprender la prevalencia y los correlatos de estas afecciones es crucial para el manejo integral del paciente.

Objetivo del estudio:

Determinar la distribución y las asociaciones clínicas de los aneurismas y disecciones extratorácicos en adultos con nsTAAD.
Identificar los predictores de aneurismas no torácicos (nTA-A) y disecciones no aórticas (nTA-D) en esta cohorte.

Principales métodos:

Estudio de cohorte retrospectivo de 3.989 pacientes con nsTAAD en Mayo Clinic (2018-2024).
Confirmación manual de lesiones vasculares torácicas y extratorácicas, excluyendo casos sindrómicos.
Análisis de datos de imagen (cabeza/cuello, tórax, abdomen/pelvis) y regresión logística para la identificación de predictores.

Principales resultados:

Los aneurismas extratorácicos (nTA-A) se detectaron en el 13,5% de los pacientes estudiados, aumentando con la edad (18,3% en ≥51 años).
Las disecciones extratorácicas (nTA-D) ocurrieron en el 3,4% de los pacientes, también aumentando con la edad.
La hipertensión y la hiperlipidemia se asociaron de forma independiente con nTA-A.
nTA-A/nTA-D se correlacionaron con tasas más altas de insuficiencia cardíaca, infarto de miocardio, accidente cerebrovascular y mortalidad.

Conclusiones:

Los aneurismas y disecciones extratorácicos son prevalentes en pacientes con nsTAAD y dependen de la edad.
Los hallazgos respaldan una evaluación clínica exhaustiva, el monitoreo de los síntomas y la optimización de los factores de riesgo.
Este estudio proporciona una base para futuras investigaciones sobre una evaluación vascular más amplia para mejorar la estratificación del riesgo en nsTAAD.

Palabras clave:

Disección aórtica Enfermedad vascular extratorácica Vigilancia por imagen Disección no aórtica Aneurisma aórtico torácico no sindrómico

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