2.0 Classification of Aortic
Dissection
Several classifications of aortic dissection are classically used
throughout the medical world, with the most significant of them being
the DeBakey and Stanford classifications (Gawinecka, Schönrath and von
Eckardstein, 2017). The DeBakey system consists of three types of
dissection: Type I, II and III (Gawinecka, Schönrath and von
Eckardstein, 2017). In Type I aortic dissection the tear arises in the
ascending aorta and may include the arch and descending aorta. In Type
II dissection the tear is confined to the ascending aorta whereas in
Type III dissection the tear is limited to the descending aorta (DEBAKEYet al. , 1965). The Stanford classification system simplifies this
and divides aortic dissection into two types: type A involving the
ascending aorta and type B, involving the descending aorta distal to the
left subclavian artery (Figure 1) (Rylski et al. , 2017;
Gawinecka, Schönrath and von Eckardstein, 2017).
INSERT FIGURE 1
However, neither of these classifications address dissections involving
the aortic arch alone or dissections comprising of the aortic arch and
the descending aorta. When the dissection is limited to the aortic arch
or can be described as a retrograde dissection arising from the
descending aorta that extends into the arch and stops before the
ascending aorta; these dissections are then termed as non-A non-B aortic
dissections (Carino et al. , 2019) (Urbanski and Wagner, 2016).
The Contemporary classifications such as the TEM (Type, Entry and
Malperfusion) aortic dissection classification include non-A non-B
dissections (Sievers et al. , 2020).