Classification of Acute Aortic Syndrome

Classic Aortic Dissection (AD), Intramural Hematoma (IMH) and Penetrating Atherosclerotic Ulcer (PAU) are distinct entities, but closely related.
This is reflected upon in their identical therapeutical strategies.
The main goal for the radiologist is not only to detect which entity is causing the clinical problem, but more importantly to differentiate between type A and B! 

Typical Aortic Dissection, Intramural Hematoma and Penetrating Aortic Ulcer.

Stanford classification

The Acute Aortic Syndrome (AAS) is classified according to Stanford.
Stanford Type A lesions involve the ascending aorta and aortic arch and may or may not involve the descending aorta.
Stanford Type B lesions involve the thoracic aorta distal to the left subclavian artery.
The Stanford classification has replaced the DeBakey classification (type I= ascending, arch and descending aorta: type II= only ascending aorta: type III= only descending aorta).
Treatment options for the 2 subgroups of the acute aortic syndrome (AAS) are very different:
- Stanford type A will be treated with surgery or endovascular therapy.
- Stanford Type B will be treated medically.