Type A aortic dissection: extensive and causing bilateral renal infarction and right external iliac artery occlusion

Case contributed by Dr Amro Omar

Presentation

Acute chest and abdominal pain.

Patient Data

Gender: Male

Extensive Type A dissection of the aorta, extending from the aortic root to both external iliac arteries. There are bilateral renal infarctions, more extensive on the left side, as both renal arteries now arise from the false lumen. Non-opacification of long segment of the right external iliac artery is seen.

Case Discussion

Two working classifications of the aortic dissection:

  • Stanford classification
    • Type A (60%): Involves ascending aorta, ± descending aorta
      • surgical treatment
    • Type B (40%): Excludes ascending aorta; involves descending aorta &/or aortic arch
      • medical management
  • DeBakey classification
    • Type I: involves ascending aorta, aortic arch, and descending aorta
    • Type II: involves ascending aorta
    • Type III: involves descending aorta distal to left subclavian artery
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Case information

rID: 36519
Case created: 27th Apr 2015
Last edited: 22nd Jun 2017
Inclusion in quiz mode: Included

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