Aortic dissection classification: Difference between revisions
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Several different classification systems have been used to describe [[aortic]] dissections. The systems commonly in use are either based on either the [[anatomy]] of the dissection ([[proximal]], [[distal]]) or the duration of onset of [[symptom]]s ([[acute]], [[chronic]]) prior to presentation. | Several different classification systems have been used to describe [[aortic]] dissections. The systems commonly in use are either based on either the [[anatomy]] of the dissection ([[proximal]], [[distal]]) or the duration of onset of [[symptom]]s ([[acute]], [[chronic]]) prior to presentation. | ||
== | ==Classification== | ||
===DeBakey | ===DeBakey Classification System=== | ||
The DeBakey system is an anatomical description of the aortic dissection. | The DeBakey system is an [[anatomy|anatomical]] description of the [[aortic]] dissection. It categorizes the dissection based on where the original [[intima]]l tear is located and the extent of the dissection (localized to either the [[ascending aorta]] or [[descending aorta]], or involves both the ascending and descending [[aorta]].<ref>DeBakey ME, Henly WS, Cooley DA, Morris GC Jr, Crawford ES, Beall AC Jr. Surgical management of dissecting aneurysms of the aorta. ''J Thorac Cardiovasc Surg'' 1965;49:130-49. PMID 14261867.</ref> | ||
* | *''Type I'' - Originates in [[ascending aorta]], propagates at least to the [[aortic arch]] and often beyond it [[distal]]ly. | ||
* | *''Type II'' – Originates in and is confined to the [[ascending aorta]]. | ||
* | *''Type III'' – Originates in [[descending aorta]], rarely extends [[proximal]]ly. | ||
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| colspan=4 bgcolor="#ABCDEF" | <small>Classification of aortic dissection</small> | | colspan=4 bgcolor="#ABCDEF" | <small>Classification of aortic dissection</small> | ||
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===Stanford Classification System=== | ===Stanford Classification System=== | ||
Divided into 2 groups; A and B depending on whether the ascending aorta is involved.<ref>Daily PO, Trueblood HW, Stinson EB, Wuerflein RD, Shumway NE. Management of acute aortic dissections. ''Ann Thorac Surg'' 1970;10:237-47. PMID 5458238.</ref> | Divided into 2 groups; A and B depending on whether the ascending [[aorta]] is involved.<ref>Daily PO, Trueblood HW, Stinson EB, Wuerflein RD, Shumway NE. Management of acute aortic dissections. ''Ann Thorac Surg'' 1970;10:237-47. PMID 5458238.</ref> | ||
* | *''A'' = ''Type I'' and ''II'' DeBakey | ||
* | *''B'' = ''Type III'' Debakey | ||
[[Image:AoDissekt scheme StanfordB.png|left|thumb|Dissection of the aorta descendens (3), which starts from the left subclavian artery, reaching to the abdominal aorta (4). Aorta ascendens (1) and aortic arch (2) are not involved.]] | [[Image:AoDissekt scheme StanfordB.png|left|thumb|Dissection of the aorta descendens (3), which starts from the left subclavian artery, reaching to the abdominal aorta (4). Aorta ascendens (1) and aortic arch (2) are not involved.]] | ||
<br clear="left"/> | <br clear="left"/> | ||
==Classification Based on Chronicity== | ==Classification Based on Chronicity== | ||
Revision as of 18:52, 24 January 2013
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Aortic dissection Microchapters |
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Diagnosis |
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Treatment |
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Special Scenarios |
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Case Studies |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Several different classification systems have been used to describe aortic dissections. The systems commonly in use are either based on either the anatomy of the dissection (proximal, distal) or the duration of onset of symptoms (acute, chronic) prior to presentation.
Classification
DeBakey Classification System
The DeBakey system is an anatomical description of the aortic dissection. It categorizes the dissection based on where the original intimal tear is located and the extent of the dissection (localized to either the ascending aorta or descending aorta, or involves both the ascending and descending aorta.[1]
- Type I - Originates in ascending aorta, propagates at least to the aortic arch and often beyond it distally.
- Type II – Originates in and is confined to the ascending aorta.
- Type III – Originates in descending aorta, rarely extends proximally.
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| Percentage | 60 % | 10-15 % | 25-30 % |
| Type | DeBakey I | DeBakey II | DeBakey III |
| Stanford A | Stanford B | ||
| Proximal | Distal | ||
| Classification of aortic dissection | |||
Stanford Classification System
Divided into 2 groups; A and B depending on whether the ascending aorta is involved.[2]
- A = Type I and II DeBakey
- B = Type III Debakey
Classification Based on Chronicity
- Chronic dissection is almost twice as common in patients with type III (45%) when compared with type I (24%) and type II dissection (27%).
References
- ↑ DeBakey ME, Henly WS, Cooley DA, Morris GC Jr, Crawford ES, Beall AC Jr. Surgical management of dissecting aneurysms of the aorta. J Thorac Cardiovasc Surg 1965;49:130-49. PMID 14261867.
- ↑ Daily PO, Trueblood HW, Stinson EB, Wuerflein RD, Shumway NE. Management of acute aortic dissections. Ann Thorac Surg 1970;10:237-47. PMID 5458238.