Aortic dissection classification

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Aortic dissection Microchapters

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Differentiating Aortic dissection from other Diseases

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Case #1


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Classification systems

Several different classification systems have been used to describe aortic dissections. The systems commonly in use are either based on the anatomy of the dissection or the duration of onset of symptoms prior to presentation.

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.
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
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.

References

  1. 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.
  2. Daily PO, Trueblood HW, Stinson EB, Wuerflein RD, Shumway NE. Management of acute aortic dissections. Ann Thorac Surg 1970;10:237-47. PMID 5458238.

Acknowledgements

The content on this page was first contributed by: David Feller-Kopman, MD and C. Michael Gibson M.S., M.D.

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