Type:
Educational Exhibit
Keywords:
Not applicable, Dissection, Acute, Education, Image manipulation / Reconstruction, CT-Angiography, Vascular, Cardiovascular system, Arteries / Aorta, Cardiac
Authors:
M. Modares1, K. Hanneman2, M. Ouzounian1, J. Chung1, E. Nguyen2; 1Toronto/CA, 2Toronto, ON/CA
DOI:
10.26044/ecr2020/C-03023
Conclusion
ADs, LITs, and IMHs are classified using the more popular Stanford classification. However, the Stanford and DeBakey classifications of ADs do not capture the entire spectrum of anatomic variants, such as arch dissections, leading to confusion and potentially inappropriate treatment.
The ACCF/AHA classification system, although more comprehensive, does not easily separated AAS into categories with similar management nor does it require description of morphologic features with prognostic impact.
In CTA reports, we recommend the Stanford classification because of its simplicity of definition and clinical relevance. However other features, such as location of the primary intimal tear, direction of false lumen propagation and its degree of thrombosis, arch involvement and its degree of angulation, and the presence of ULPs or IBPs, have prognostic impact and must be included by radiologists to communicate with surgeons to guide appropriate management.