Abstract:

Introduction: intramural hematoma of the aortic wall is a component of acute aortic syndrome, and is also considered a precursor of aortic dissection. Due to peculiarities of the natural course, there are significant disagreements in choosing the optimal strategy for the treatment of intramural hematoma.

Aim: was to evaluate the possibility of a differential tactical approach to the treatment of acute intramural aortic hematoma in various situations.

Material and methods: two clinical cases demonstrate different approaches to the treatment of intramural aortic hematoma.

Results: in given clinical examples, a conservative tactics of managing patients with intramural hematoma of the aorta "watch and wait" was applied. However, in the first case, an emergency surgical intervention was required, due to the complicated course of the disease, according to dynamic studies. The second case demonstrated the acceptability of a conservative approach with long-term monitoring of the condition of the aortic wall.

Conclusions: the balance between risks of surgery and the safety of conservative therapy is the cornerstone in deciding on the optimal tactics for treating this pathology.