Classification

• Stanford type A aortic dissection: any dissection involving the ascending aorta (defined as proximal to the brachiocephalic artery), regardless of origin

  • Can extend proximally to the aortic valve and distally to the descending aorta

  • Generally requires surgery

  • Complications include aortic regurgitation and cardiac tamponade.

• Stanford type B aortic dissection: any dissection not involving the ascending aorta

  • Descending aorta; originating distal to the left subclavian artery

  • Most cases can be managed with medical therapy (e.g., beta blockers, vasodilators).

Stanford A = Affects ascending aorta; Stanford B = Begins beyond brachiocephalic vessels

• Type I

  • Dissections originate in the ascending aorta and continue to at least the aortic arch but typically as far as the descending aorta.

  • Generally requires surgery

• Type II

  • Dissections originate in, and are restricted to, the ascending aorta.

  • Generally requires surgery

• Type III

  • Dissections originate in the descending aorta and most often extend distally.

  • Most cases can be managed by medical therapy.

  • Can be further subdivided into:

    • Type IIIa: limited to the descending thoracic aorta above the level of the diaphragm

    • Type IIIb: extends below the diaphragm