Classic Aortic Dissection is the most common entity causing an acute aortic syndrome (70%).
- Incidence: 1-10 : 100.000
- mostly men
- rarely < 60 year (etiology = media degeneration)
- hypertension > 70%
- Type A mortality 1-2% per hour after onset of symptoms, total up to 90% non-treated, 40% when treated.
- 1 year survival Type B up to 85% if medically treated (5 year > 70%).
Classic Aortic Dissection |
Management decisions are based on the following information:
- Type A or Type B
- Place of entry & re-entry
- Side branches involved, originating form true / false lumen
- Organs at risk (1/3 of mortality is caused by organ failure)
- Complications (rupture, coronairy occlusion, aortic insufficiency, neurological )
- Diameters of true and false lumina at: proximal and distal landing zones, at entry and at minimum
- Iliac vessel tortuosity
LEFT: Type A dissection with clear intimaflap seen within the aortic arch. RIGHT: Type B dissection. Entry point distal to left subclavian artery. |
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