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Classification

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Classification of aortic dissection is based on the anatomic involvement of the condition. There are two classification systems in use (1).

De Bakey (1965) - an older system primarily used for auditing the results of treatment, categorizes dissections based on the origin of the intimal tear and the extent of the dissection:

  • type I:
    • tear originates in the ascending aorta
    • extends at least to the aortic arch and often beyond it distally
  • type II:
    • tear originates in the ascending aorta
    • dissection is confined to the ascending aorta
  • type III:
    • tear originates in the descending aorta
    • dissection confined to descending aorta either stopping above the diaphragm (IIIa) or extending below the diaphragm (IIIb)

Stanford system - a simpler and newer system which has therapeutic significance and divides dissections into 2 categories, those that involve the ascending aorta and those that do not:

  • type A:
    • dissection involves the ascending aorta with or without extension into the descending aorta i.e. De Bakey types I and II
    • accounts for 66% of cases
  • type B:
    • dissection confined to the descending aorta, beginning distal to the subclavian artery i.e. De Bakey type III
    • accounts for 34% of cases

Reference:


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