Tortuous aorta vs normal aorta

Surgery. Open-chest surgery for thoracic aortic aneurysm Enlarge image. Ascending aortic root aneurysm procedure Enlarge image. Endovascular repair for thoracic aortic aneurysm Enlarge image. Surgery is generally recommended for thoracic aortic aneurysms about 1.9 to 2.4 inches (about 5 to 6 centimeters) and larger.

Tortuous or twisted arteries and veins are commonly seen in humans and animals [ 1, 2, 3 ]. While mild tortuosity is a common anomaly without clinical symptoms, severe tortuosity can lead to various serious symptoms. Clinical observations have linked tortuous arteries and veins to aging, atherosclerosis, hypertension, genetic defects and ...The management of thoracic aortic aneurysm is reviewed here. The etiology, natural history, clinical features, and diagnosis of TAA, as well as specific techniques for repair of the thoracic aorta, are discussed separately. (See "Epidemiology, risk factors, pathogenesis, and natural history of thoracic aortic aneurysm and dissection" and ...Jul 24, 2023 · The aorta is the largest vessel within the human body. It originates from the left ventricle of the heart anterior to the pulmonary artery before arching posteriorly and descending along the posterior mediastinum. It descends to the level of the L4 vertebral body where it bifurcates into the left and right common iliac arteries. It is the main artery in the body and distributes oxygenated ... Dizziness or lightheadedness. Rapid heart rate. Sudden, severe chest pain, abdominal pain or back pain. Finding an aortic aneurysm before it ruptures offers your best chance of recovery. As an aortic aneurysm grows, you might notice symptoms including: Difficulty breathing or shortness of breath.1. Introduction. In a 2016 statement, the guidelines for the diagnosis and management of patients with thoracic aortic disease was amended to recommend prophylactic repair of the ascending aorta in asymptomatic patients with bicuspid aortic valves (BAV) when the maximum aortic diameter is >5 cm and patients have other risk factors for aortic dissection, such as hypertension, a family history ...Symptoms. Aortic dissection symptoms may be similar to those of other heart problems, such as a heart attack. Typical signs and symptoms include: Sudden severe chest or upper back pain, often described as a tearing or ripping sensation, that spreads to the neck or down the back. Sudden severe stomach pain. Loss of consciousness.The aorta, the great artery, is the largest artery of the human body and carries oxygenated blood ejected from the left ventricle to the systemic circulation. It is divided into: thoracic aorta. ascending aorta. aortic arch.Abstract. Objective: Tortuosity in the descending thoracic aorta (DTA) comes with aging and increases the risk of endoleaks after TEVAR. With this report, we would like to define and classify tortuosity in the DTA of patients with thoracic aortic disease. Methods: Retrospective case-control study of two hundred seven patients, comparing sixty ...

Computed tomography (CT) of the chest demonstrated an enlarged, tortuous aorta (Fig. 2). The diameters of the ascending thoracic aorta, the descending thoracic aorta, and the proximal abdominal aorta were 7 cm, 6 cm, and 5.3 cm, respectively. There was an intramural thrombus at the level of the descending aorta.The thoraco-abdominal aorta is tortuous. Included abdominal aorta shows dilated and tortuous branches of the coeliac axis. The main pulmonary artery is short with early bifurcation with long tubular configuration and parallel proximal course of the right and left main pulmonary arteries (arrowheads in C). Normal morphology of bilateral ...Mar 22, 2023 · 3D aortic segmentations for a representative young subject (panel a) and an old subject (panel b). A more tortuous aorta can be seen in the old subject. Panel a also shows the four aortic segments used for regional analysis in this study: ascending aorta (AAo), descending aorta (DAo), suprarenal and infrarenal abdominal aorta (SAA and IAA). • Aortic Valve morphology • Normal Aortic size in the adult: –Aoroot < 40 mm –Ascending Ao< 37 mm –Descending Aorta < 28 mm • These values are, however, very variable. 1/9/2018 8 Aortic size to be adjusted ... ‐Tortuous Aorta ‐Frequent follow‐ups ‐Semi‐invasive. 1/9/2018 13 MRIWhich one of the following statements regarding aortic trauma is true? a. The mediastinal width is at least 8 cm. b. Mediastinal hematoma is specific for aortic injury. c. Ascending aorta is the most common sight of aortic injury. d. Computed tomography (CT) angiography is the definitive test for aortic injury. e. Right flail chest excludes ..."We're always in pursuit of the perfect tan. We never stop looking for great places to 'lay out ...'" While a regular traveler may disembark from a plane and eagerly snap a shot of...In a normal ascending aorta, the diameter at sinus level is the largest, followed by the sinotubular junction and the aortic annulus. If aortic dilatation is detected at any level, its maximum diameter should be measured and reported. Normal values. ... TOE may make oblique measurements when the descending aorta is elongated or tortuous. …

Aneurysms can occur along the entire length of the aorta, with the infrarenal location being the most common . The standard definition for an infrarenal AAA is a transverse aortic diameter ≥3.0 cm. Other studies have used a definition of 1.5 to 2.0 times the normal adjacent aortic diameter.Obtaining adequate quality 3D volume-rendered CT images for all patients was feasible in convenient time (4 to 10 minutes). Images show that the aorta becomes tortuous in scoliosis patients, following the curve of the spine either right or left, compared with the straight path of the aorta in normal control subjects (Figure 3).The aortic arch is the section of the aorta between the ascending and descending aorta. As it arises from the ascending aorta, the arch runs slightly backward and to the left of the trachea. The distal segment of the aortic arch then traverses downwards at the fourth thoracic vertebra. From this point on, it continues as the …The splenic artery (limb of the celiac T toward patient’s left; Fig. 23.2) follows a tortuous course along the posterosuperior margin of the pancreatic body and tail ( Fig. 23.3A) and terminates by splitting into a number of branches in the hilum of the spleen. Along the way, the splenic artery gives rise to several pancreatic branches, short ...

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A TAA is considered serious. The bulge in your thoracic aorta can become weak, and the force of normal blood pressure can cause it to rupture. This can lead to ...This iceberg knows it looks like a sheet cake but it would like you to leave it alone. At some point someone said, “there are no right angles in nature,” and then everyone believed...In a study of 338 patients 65 years old or younger with chest pain, aortic root calcium was weakly associated with an abnormal myocardial perfusion study (54.9% vs. 41.5%; p < 0.05) (26). However, when calcifications involving the aortic valve leaflets and mitral annulus were also considered, the association strengthened (odds ratio [OR]: 2.12 ...A TAA is considered serious. The bulge in your thoracic aorta can become weak, and the force of normal blood pressure can cause it to rupture. This can lead to ...

seen in 70% of cases presenting in older children or adults. if the coarctation is distal to either subclavian artery, then increased flow occurs through the subclavian artery, forming a collateral pathway via the internal thoracic artery, anterior intercostal artery, posterior intercostal artery and then into the descending thoracic aorta.The normal caliber of the abdominal aorta increases with age; at the renal hila, its mean diameter varies from about 1.5 cm in women in the fourth decade of life to about 2 cm in men in the eighth decade. 3,4. The abdominal aorta has three ventral branches ( Figs. 7-1 and 7-2 ). The celiac artery arises at the T12-L1 level.Arterial tortuosity syndrome (ATS) is characterized by widespread elongation and tortuosity of the aorta and mid-sized arteries as well as focal stenosis of segments of the pulmonary arteries and/or aorta combined with findings of a generalized connective tissue disorder, which may include soft or doughy hyperextensible skin, joint …Mar 22, 2023 · 3D aortic segmentations for a representative young subject (panel a) and an old subject (panel b). A more tortuous aorta can be seen in the old subject. Panel a also shows the four aortic segments used for regional analysis in this study: ascending aorta (AAo), descending aorta (DAo), suprarenal and infrarenal abdominal aorta (SAA and IAA). The aorta is the largest artery in your body and carries blood from your heart and lungs to everywhere else. Although your aorta is thick and large (running the length of your chest and abdomen ... Thoracic Aortic Aneurysms. Thoracic aneurysms may involve one or more aortic segments (aortic root, ascending aorta, arch, or descending aorta) and are classified accordingly ( Figure 1 ). Sixty percent of thoracic aortic aneurysms involve the aortic root and/or ascending aorta, 40% involve the descending aorta, 10% involve the arch, and 10% ... This iceberg knows it looks like a sheet cake but it would like you to leave it alone. At some point someone said, “there are no right angles in nature,” and then everyone believed...Mar 22, 2023 · BackgroundIncreased vascular tortuosity is a hallmark of ageing of the vascular system, including the aorta. However, the impact of tortuosity on aortic blood flow is unknown. We hypothesized that increased tortuosity would be associated with increased blood flow helicity and with decreased degree of blood flow turbulence as measured by the turbulent kinetic energy (TKE).Methods4D Flow MR ... The location and shape of the aortic root dilatation may provide clues to the aetiology of the ascending aortic aneurysm. The aorta in Marfan syndrome is typically pear‐shaped, being largest at the sinuses of Valsalva, with the ascending aorta tapering to normal calibre at the origin of the innominate artery (fig 3 3).). Aortic aneurysm in ...

Overview. Coarctation of the aorta Enlarge image. The aorta is the largest artery in the body. It moves oxygen-rich blood from the heart to the rest of the body. …

When aortic aneurysms are found incidentally, it is advisable to seek a cardiothoracic opinion when the ascending and descending aortas are more than 4.5 and 5.5 cm, respectively, in diameter so that appropriate monitoring can be instituted. Normal growth rate of all types of thoracic aneurysms averages 0.12 cm per year .BackgroundIncreased vascular tortuosity is a hallmark of ageing of the vascular system, including the aorta. However, the impact of tortuosity on aortic blood flow is unknown. We hypothesized that increased tortuosity would be associated with increased blood flow helicity and with decreased degree of blood flow turbulence as measured by …Tortuous or twisted arteries and veins are commonly seen in humans and animals [ 1, 2, 3 ]. While mild tortuosity is a common anomaly without clinical symptoms, severe tortuosity can lead to various serious symptoms. Clinical observations have linked tortuous arteries and veins to aging, atherosclerosis, hypertension, genetic defects and ...Results The length of the thoracic aorta was significantly related to age (r=0.54) and increased by 59 mm (males) or 66 mm (females) between the ages of 20 and 80 years. Elongation was most pronounced in the proximal descending aorta, which showed an almost 2.5-fold length increase during life. The lengthening of the thoracic aorta was ...A TAA is considered serious. The bulge in your thoracic aorta can become weak, and the force of normal blood pressure can cause it to rupture. This can lead to ...The normal aortic valve is a three leaflets structure that separates the ascending aorta from the left ventricle, which is the main pumping chamber of the heart. During the contraction of the heart, the aortic valve typically opens three to five square centimeters. As the heart relaxes, this valve then closes and prevents leakage of blood …Aortic dissection can occur even with normal aortic dimensions, as illustrated by the CT scans (Fig. 3). Therefore, education of the affected individual and their family is important, so that they ensure urgent review if they suffer any chest pain. Annual MRA scanning of the aorta is mandated and if there is evidence of serial growth then ...410-955-5000 Maryland. 855-695-4872 Outside of Maryland. +1-410-502-7683 International. Coarctation of the aorta is an abnormal narrowing of the aorta. The aorta is the large blood vessel that exits the heart. Transcatheter repair is a type of procedure that can treat the aorta without the need for open heart surgery.Aug 30, 2014 · Radiological signs in arterial tortuosity syndrome: Aortic elongation sign. (a and b) 4-month-old female with dysmorphic features and abnormal echo was diagnosed with ATS. Elongated tortuous aorta projects laterally (arrow). Sign is particularly useful in younger patient where the aortic knuckle is normally inconspicuous. 410-955-5000 Maryland. 855-695-4872 Outside of Maryland. +1-410-502-7683 International. Coarctation of the aorta is an abnormal narrowing of the aorta. The aorta is the large blood vessel that exits the heart. Transcatheter repair is a type of procedure that can treat the aorta without the need for open heart surgery.

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Many who voted for the UK's exit from the EU now want back in, according to polls Few people, it’s safe to say, enjoyed the tortuous process of negotiating Brexit. Extricating the ...Aortic coarctation (ko-ahrk-TAY-shun) is a narrowing of the aorta. It forces the heart to pump harder to move blood through the aorta. Coarctation of the aorta is generally present at birth (congenital heart defect). Symptoms can range from mild to severe. The condition might not be detected until adulthood.The Aorta. The aorta is the largest artery in the body, initially being an inch wide in diameter. It receives the cardiac output from the left ventricle and supplies the body with oxygenated blood via the systemic circulation. The aorta can be divided into four sections: the ascending aorta, the aortic arch, the thoracic (descending) aorta and ...Pathology. Location. Aneurysmal dilatation can affect any part of the thoracic aorta. Relative frequencies are (with some involving more than one segment) 7: aortic …Abdominal aortic aneurysm treatment options may include: Endovascular repair. This treatment is most often used to repair an abdominal aortic aneurysm. A surgeon inserts a thin, flexible tube, called a catheter, through an artery in the groin area and guides it to the aorta. A metal mesh tube on the end of the catheter is placed at the site of ...Introduction: Tortuosity in the descending thoracic aorta is becoming more important since thoracic endovascular aortic repair (TEVAR) is the gold standard for treating thoracic aortic disease. The literature reports that tortuosity has an influence on the occurrence of endoleaks1. There is some literature defining the angulation and tortuosity of the aortic arch. Recently, a new ...A TAA is considered serious. The bulge in your thoracic aorta can become weak, and the force of normal blood pressure can cause it to rupture. This can lead to ...An aneurysm usually occurs where the wall has become weak and has lost its elastic properties, so it doesn't return to its normal shape after the blood has ...A TAA is considered serious. The bulge in your thoracic aorta can become weak, and the force of normal blood pressure can cause it to rupture. This can lead to ... ….

Feb 7, 2024 · Echocardiography revealed moderate left ventricular hypertrophy, a small secundum atrial septal defect, normal Doppler interrogations across all the valves, difficult visualization of the ascending aorta, and peak instantaneous pressure gradient of 49 mmHg across it. The aortic valve was normal. There were no Marfanoid features. In these aorta segments, it is particularly important to avoid off-axis imaging that can overestimate the aortic diameter in patients with tortuous aorta courses. Therefore, adequate MPRs with CT/CMR should be warranted. ... Reported reference maximum normal aortic diameters values at different segments of the aorta are shown …Get ratings and reviews for the top 6 home warranty companies in Normal, IL. Helping you find the best home warranty companies for the job. Expert Advice On Improving Your Home All...When a weak area of your thoracic aorta expands or bulges, it is called a thoracic aortic aneurysm (TAA). Approximately 25 percent of aortic aneurysms occur in the chest and the rest occur in the abdomen. Thoracic aneurysms affect approximately 15,000 people in the United States each year. TAAs are serious health risks because they can burst or ...The size of the aorta decreases with distance from the aortic valve in a tapering fashion. The normal diameter of the ascending aorta has been defined as <2.1 cm/m 2 and of the descending aorta as <1.6 cm/m 2. 1 The normal diameter of the abdominal aorta is regarded to be less than 3.0 cm. The normal range has to be corrected for age and sex ...Get ratings and reviews for the top 6 home warranty companies in Normal, IL. Helping you find the best home warranty companies for the job. Expert Advice On Improving Your Home All...6 tortuous aorta patients report severe depressed mood (13%) 14 tortuous aorta patients report moderate depressed mood (30%) 17 tortuous aorta patients report mild depressed mood (36%) 9 tortuous aorta patients report no depressed mood (19%)We are never going back to the days where venture capital firms can win by being the only term sheet on the table. Though this may be a tough pill for some investors, we are never ...Oct 30, 2023 · An aortic aneurysm is diagnosed when the increase in aortic wall diameter is 1.5 times more than its normal size. Since the normal diameter of the ascending aorta amounts to about 3.5 cm, and 2.5 cm for the abdominal aorta, the diagnostic criteria for an aneurysm include a diameter of >5cm for the ascending aorta, and >4cm for the abdominal aorta. Tortuous aorta vs normal aorta, Citation, DOI, disclosures and article data. The term unfolded aorta refers to the widened and decreased curvature of the aortic arch on a frontal chest radiograph giving an ‘opened up’ appearance. It is one of the more common causes of apparent mediastinal widening and is seen with increasing age, usually associated with aortic calcification., Citation, DOI, disclosures and article data. The term unfolded aorta refers to the widened and decreased curvature of the aortic arch on a frontal chest radiograph giving an ‘opened up’ appearance. It is one of the more common causes of apparent mediastinal widening and is seen with increasing age, usually associated with aortic calcification., Ribs demonstrate a normal configuration. Vascular tortuosity. Under the category of large vessel involvement, most striking observations are noted in the tortuosity and dilatation of the aortic arch. ... Coronal CT image shows lateral location of the tortuous aorta (empty arrows) reaching to mid-thoracic cavity. (b) 1-month-old female with ..., seen in 70% of cases presenting in older children or adults. if the coarctation is distal to either subclavian artery, then increased flow occurs through the subclavian artery, forming a collateral pathway via the internal thoracic artery, anterior intercostal artery, posterior intercostal artery and then into the descending thoracic aorta., seen in 70% of cases presenting in older children or adults. if the coarctation is distal to either subclavian artery, then increased flow occurs through the subclavian artery, forming a collateral pathway via the internal thoracic artery, anterior intercostal artery, posterior intercostal artery and then into the descending thoracic aorta., Arterial tortuosity syndrome (ATS) is characterized by widespread elongation and tortuosity of the aorta and mid-sized arteries as well as focal stenosis of segments of the pulmonary arteries and/or aorta combined with findings of a generalized connective tissue disorder, which may include soft or doughy hyperextensible skin, joint hypermobility..., We have presented a case of a ruptured descending aortic aneurysm that was accompanied by extreme tortuosity and a pseudocoarctation at the level of the ligamentum arteriosum. We performed successful endovascular repair, covering the left subclavian artery, using a transapical-to-femoral artery (through-and-through) guidewire …, Often patients with bicuspid valves requiring valvular surgery will need aortic root replacement at the time of surgery. An aortic root diameter of 5 cm is an indication for surgery, or 4.5 cm if valvular surgery is also planned concurrently. 1 This surgery is undertaken to prevent future aneurysm complications including dissection or rupture., The size of the aorta decreases with distance from the aortic valve in a tapering fashion. The normal diameter of the ascending aorta has been defined as <2.1 cm/m 2 and of the descending aorta as <1.6 cm/m 2. 1 The normal diameter of the abdominal aorta is regarded to be less than 3.0 cm. The normal range has to be corrected for age and sex ..., Mar 22, 2023 · BackgroundIncreased vascular tortuosity is a hallmark of ageing of the vascular system, including the aorta. However, the impact of tortuosity on aortic blood flow is unknown. We hypothesized that increased tortuosity would be associated with increased blood flow helicity and with decreased degree of blood flow turbulence as measured by the turbulent kinetic energy (TKE).Methods4D Flow MR ... , Do you ever feel as if your life is about suffering? Do you ever feel that you suffer needlessly? I recently r Do you ever feel as if your life is about suffering? Do you ever feel..., Future works could measure local or segmental tortuosity of the thoracic aorta requiring very detailed centerline measurement using automated methods on 3D aortic acquisitions. Furthermore, the study sample does not allow to generalize results to define normal aortic arch values for an individual., The risk also is increased for an aortic or other blood vessel dissection or rupture. Bicuspid aortic valve. Having an aortic valve with two cusps instead of three increases the risk of aortic aneurysm. Complications. Tears in the wall of the aorta and rupture of the aorta are the main complications of thoracic aortic aneurysm., Acute aortic occlusion, studied via translumbar aortogram. There are atherosclerotic renal arteries and a normal superior mesenteric artery. (B). Another patient demonstrates chronic aortic occlusion. There is a markedly enlarged and tortuous inferior mesenteric artery providing collateral flow. FIGURE 20-5. (A)., The aortic valve is located between the bottom left chamber of your heart, the left ventricle, and the main artery that leads away from your heart, the aorta. ... Your heart has to work harder to squeeze blood through the narrow valve than it does when the valve opening is normal. Aortic stenosis can be caused when a person is born with an ..., Apr 23, 2019 · The descending thoracic aorta (DTA) was analyzed and was divided into four zones of equal length. Subjects were divided into three groups based on their maximum tortuosity value: low (< 30°), moderate (30° - 60°) and high (> 60°). A linear regression model was built to test the effect of age and gender on tortuosity. , Aortic coarctation (ko-ahrk-TAY-shun) is a narrowing of the aorta. It forces the heart to pump harder to move blood through the aorta. Coarctation of the aorta is generally present at birth (congenital heart defect). Symptoms can range from mild to severe. The condition might not be detected until adulthood., Thoracic Aortic Aneurysms. Thoracic aneurysms may involve one or more aortic segments (aortic root, ascending aorta, arch, or descending aorta) and are classified accordingly ( Figure 1 ). Sixty percent of thoracic …, In a study of 338 patients 65 years old or younger with chest pain, aortic root calcium was weakly associated with an abnormal myocardial perfusion study (54.9% vs. 41.5%; p < 0.05) (26). However, when calcifications involving the aortic valve leaflets and mitral annulus were also considered, the association strengthened (odds ratio [OR]: 2.12 ..., Other studies have suggested that altered flow profiles through tortuous arteries could lead to more severe distal aortic phenotypes and susceptibility to aortic dissections . In conclusion, ATS is a complex phenomenon influenced by mechanical and anatomic factors, and it is a feature observed in various genetically mediated conditions., Fig. 8.3 • (A) LS demonstrating an aneurysm of the lower abdominal aorta, just proximal to the bifurcation. IA, iliac artery. (B) LS through the aorta demonstrating an aneurysm containing thrombus. Measurement should be perpendicular to the axis of the aorta and include the adventitia (‘outer to outer’). (Ci) A large AAA full of thrombus ..., The aorta tapers distally, with the normal descending aorta always smaller in caliber than the ascending aorta in healthy individuals. The proximal descending aorta is considered abnormal when it exceeds 2.63 cm, and the distal descending aorta is considered abnormal when it exceeds 2.43 cm in diameter [ 7 , 8 ]., The aorta is the largest artery in the body. It carries oxygen-filled blood from the heart to different organs in the body. The aorta starts at the heart’s left ventricle, arches upwards towards the neck, then curves back downward, extending into the abdomen. Learn more about the important role the aorta plays in the body., When aortic aneurysms are found incidentally, it is advisable to seek a cardiothoracic opinion when the ascending and descending aortas are more than 4.5 and 5.5 cm, respectively, in diameter so that appropriate monitoring can be instituted. Normal growth rate of all types of thoracic aneurysms averages 0.12 cm per year ., The aorta, the great artery, is the largest artery of the human body and carries oxygenated blood ejected from the left ventricle to the systemic circulation. It is divided into: thoracic aorta. ascending aorta. aortic arch., Apr 25, 2023 · An abdominal aortic aneurysm is an enlarged area in the lower part of the body's main artery, called the aorta. The aorta runs from the heart through the center of the chest and belly area, called the abdomen. The aorta is the largest blood vessel in the body. An abdominal aortic aneurysm that ruptures can cause life-threatening bleeding. , Aortic valve calcification may be an early sign that you have heart disease, even if you don't have any other heart disease symptoms. Signs and symptoms of heart valve disease may include: Abnormal sound (heart murmur) when a doctor is listening to the heart beating with a stethoscope. Fatigue. Shortness of breath, particularly when you …, Coarctation of the aorta accounts for approximately 7% of all live births with congenital heart disease and is 1.7 times more common in males. w10 w11 Hypoplasia of the aortic arch to various degrees is a common accompanying feature. w12 There is a significant association with other cardiac lesions (ventricular septal defect, patent arterial duct, and …, The size of the aorta decreases with distance from the aortic valve in a tapering fashion. The normal diameter of the ascending aorta has been defined as <2.1 cm/m 2 and of the descending aorta as <1.6 cm/m 2. 1 The normal diameter of the abdominal aorta is regarded to be less than 3.0 cm. The normal range has to be corrected for age and sex ..., Aortic aneurysm surgery. Your doctor may recommend surgery if your aneurysm is big -- more than 2 inches (5 centimeters), or if it's getting larger quickly -- growing more than 3/16 inch (0.5 ..., Not related: THe two problems are not related. A tortuous aorta tht is not enlarged significantly is not a great concern. In general there is nothing to worry about if the aortic diameter is less than 5 cm and intervention in the chest is not recommended in most cases unless diameter of 5.5-6 cm NO dilation no worry, Computed tomography (CT) of the chest demonstrated an enlarged, tortuous aorta (Fig. 2). The diameters of the ascending thoracic aorta, the descending thoracic aorta, and the proximal abdominal aorta were 7 cm, 6 cm, and 5.3 cm, respectively. There was an intramural thrombus at the level of the descending aorta., Knowing that the aorta becomes more tortuous and longer with age can help to improve future generations of stent grafts to obtain less complications and better outcomes. When Ishimaru introduced the classification of the thoracic aorta in 1996, zone 4 (the DTA) was divided into different zones correlated to the thoracic vertebras[ 10 ].