Aortic Dissection
Aortic Dissection: A Life-threatening Condition with Poor Clinical Outcomes
Aortic dissection is a tear in the inner layer of the aortic wall that creates a new channel for blood flow. As blood flows through this ‘false lumen’, normal blood flow to other parts of the body will slow or stop.
There are two types of aortic dissection
Type A
Type A, the more common form of aortic dissection, involves the ascending aorta and may progress to the thoracoabdominal aorta. Type A dissections are a life-threatening condition which may cause the aorta to
Type B
Type B dissection involves the descending thoracic or thoracoabdominal aorta, without involvement of the ascending aorta. Type B dissections is classified as hyperacute, acute, subacute and chronic when relating to the time since onset of symptoms. Type B dissections are also classified according to their acuity as complicated, high-risk or uncomplicated dissections . Complicated dissections are associated with rupture or reduced blood flow to vital organs, while patients with high-risk dissection present different clinical or imaging symptoms putting them at high-risk of early r late complications. Evidence accumulates that such patients require immediate intervention via open or endovascular surgery.
Current treatment options for Type B aortic dissection (TBAD) include surgical replacement or, endovascular stent graft. Each treatment option brings procedural complexity and is associated with 15-50% mortality rate, a rate of approx. 15% of neurological complic ations [], in particular permanent paraplegia, and a reoperation rate often superior to 15%.[]
2. Lombardi 2020, Society for Vascular Surgery (SVS) and Society of Thoracic Surgeons (STS) reporting standards for type B aortic dissections.
3. Kenneth J. CherryJr. MD, Michael D. Dake MD, in Comprehensive Vascular and Endovascular Surgery (Second Edition), 2009
