Stanford classification of aortic dissection

Along with the DeBakey classification, the Stanford classification 7 is used to separate aortic dissections into those that need surgical repair, and those that usually require only medical management. The Stanford classification divides dissections by the most proximal involvement:

  • type A: A affects ascending aorta
    • accounts for ~60% of aortic dissections
    • surgical management
    • may result in:
  • type B: B begins beyond brachiocephalic vessels
    • accounts for ~40% of aortic dissections
    • dissection commences distal to the left subclavian artery
    • medical management with blood pressure control

A special case that is neither reflected in the original Stanford nor the DeBakey classification are dissections that involve the aortic arch but not the ascending aorta (between 8 and 15% of all aortic dissections 4). The nomenclature of these arch dissections has been incoherent for decades and still is.

American surgical consensus (2020) 5 defines types A and B according to the location of the intimal tear (both types with additional qualifiers for proximal and distal extent):

  • type A: dissections with a tear in the ascending aorta including a segment with the branching of the brachiocephalic trunk
  • type B: all dissections with proximal tear distal to the branching of the brachiocephalic trunk

In contrast, a European surgical consensus document (2018) 6 recognizes dissections of the arch without involvement of the ascending aorta as a distinct category, termed "non-A-non-B dissection":

  • type A: proximal extent in ascending aorta
  • non-A-non-B dissection: retrograde extent or proximal tear in the arch between the brachiocephalic trunk and left subclavian artery
  • type B: proximal extent in descending aorta distal to left subclavian artery

Article information

rID: 2081
Synonyms or Alternate Spellings:
  • Stanford classification of aortic dissection
  • Stanford classification of aortic dissections

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Cases and figures

  • Figure 1: type A
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  • Figure 2: type B
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  • Case 1: type A
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  • Case 2: type B
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  • Case 3: type B
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  • Case 4: type A
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  • Case 5: type A
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  • Case 6: type A
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  • Case 7: type A
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  • Case 8: type B
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  • Case 9: type A
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  • Case 10: type A
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  • Case 11: type A
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