ABSTRACT
Aortic dissection is the most common of the acute aortic syndromes and occurs when the aortic intima separates from the media and adventitia.1 Once a dissection ap is initiated via an ‘entry tear’, intimal disruption can propagate in either an anterograde or a retrograde direction, before re-entering the normal circulation. e resulting false lumen may compress the true aortic lumen, the ostia of aortic branches or expand rapidly due to weakening of the aortic wall. An insidious clinical presentation can delay diagnosis and this contributes to the high pre-hospital and in-hospital mortality observed in population studies.2 e incidence of this condition appears to be increasing, with a 9/100,000 rate of dissection-related hospital admissions reported per year in the United Kingdom and 3/100,000 per year operations for dissection reported in the United States.3,4
Various attempts have been made to classify aortic dissections based mainly on the management options available in each situation. e most commonly used of these are the Stanford (type A/B) or DeBakey (types I, II and III) classication systems.1,5 Both type I/II DeBakey and Stanford type A dissections originate within the ascending aorta, whereas type III DeBakey and Stanford type B begin in the descending aorta and extend into the aorta distally. DeBakey type III is subdivided into IIIa which terminates above the diaphragm and IIIb which continues
distally into the abdominal aorta and beyond. e classication of dissections that originate in the aortic arch is controversial.
