Aortic Dissection

Aortic dissection
Commonest aortic emergency
Incidence is twice that of ruptured abdominal
aortic aneurysm
Rare less than 40 years of age
Most commonly seen between 50 and 70
years
Male:female ratio is equal
Associated with hypertension, Marfans
syndrone, bicuspid aortic valve

3849777 KYH

Types of Aortic Syndromes

Classification of Variants of Aortic Dissection

Class
1

Description
Separation of intima/media; dual lumens (classic)

Intramural hematoma separation of intima/media; no

intraluminal tear or flap imaged

Intimal tear without hematoma (limited dissection) and

eccentric bulge

Atherosclerotic penetrating ulcer; ulcer usually

penetrating to adventitia with localized hematoma

Iatrogenic/traumatic dissection

Circulation. 1999;99:1331-1336

Therapeutic management
Medical treatment
Surgical treatment

Surgery in type A dissection

Surgery in type B dissection

Interventional therapy

Fenestration
Stent-Graft placement

Interventional Therapy in Aortic

Dissection
Interventional therapy in aortic dissection provides
new approaches to handle complications.
Aortic fenestration with or without stent placement
allows immediate relief of organ malperfusion for:

Visceral / Renal/ Limb ischaemia either before or after

surgical treatment

Graft stent implantation is an evolving technique

which opens new avenues to treat type B (type III)
dissection. Occlusion of entry tears induces thrombus
formation and vessel wall healing.

Stent-Graft in Aortic Dissection

Percutaneous Separate Stent-Graft

Radiology 2001; 220:533-539