Skip to main content
WoMWeb of Medicine
SearchGraphHistory
Cardiology›Condition·Updated Apr 17, 2026·v1

Aortic Dissection

Aortic dissection is a high-mortality emergency requiring rapid classification and stabilization. Type A involves the ascending aorta and requires emergent surgery, while Type B is often managed with aggressive blood pressure control unless complications like malperfusion occur. Immediate anti-impulse therapy targeting a heart rate <60 and SBP 100-120 is mandatory.

High Evidence273 references·1,011 words·5 min read·v1
Aortic DissectionAcute Aortic SyndromeCardiologyVascular SurgeryEmergency Medicine

Quick Reference

RxDrug of choiceEsmolol (IV beta-blocker) for heart rate and dP/dt control.
AltAlternativesLabetalol (IV), Propranolol (IV), or Nicardipine (IV vasodilator, only after beta-blockade).
⊘AvoidThrombolytics, anticoagulants (initially), and pure vasodilators (e.g., Hydralazine) without prior beta-blockade.
DxTest of choiceComputed Tomographic Angiography (CTA) of the chest, abdomen, and pelvis.
ScKey scoreAortic Dissection Detection Risk Score (ADD-RS).
→When to referAll Stanford Type A (emergent surgery); Complicated Type B (urgent TEVAR); All patients for long-term multidisciplinary aortic clinic follow-up.
Type A is a surgical emergency; Type B is medical unless complicated; Anti-impulse therapy (HR <60, SBP 100-120) is the immediate priority.
Aortic dissection (AD) is a catastrophic cardiovascular emergency characterized by an intimal tear that allows blood to enter the aortic media, creating a life-threatening "false lumen." It is the most common manifestation of [[Acute Aortic Syndrome]] (AAS). The condition is traditionally classified by the Stanford system: Type A involves the ascending aorta and is a surgical emergency, while Type B involves only the descending aorta and is often managed medically. Clinical suspicion must remain high as AD is a "great masquerader," often mimicking myocardial infarction or pulmonary embolism.

Overview and Recommendations

Background

  • •Understand that aortic dissection involves the longitudinal separation of the aortic wall layers, typically initiated by an intimal tear or primary medial hemorrhage that creates a false lumen separate from the true lumen.
  • •Classify the condition using the Stanford system: Type A involves the ascending aorta (regardless of the tear site) and requires emergent surgery, while Type B is distal to the left subclavian artery and is primarily managed medically unless complications arise.
  • •Recognize the temporal phases of the disease: Hyperacute (within 24 hours), Acute (1–14 days), Subacute (15–90 days), and Chronic (beyond 90 days), noting that the acute phase carries the highest risk of spontaneous rupture.
  • •Identify key risk factors, most notably chronic (associated with a 2.5-fold increased risk), bicuspid aortic valve, and genetic connective tissue disorders such as or Loeys-Dietz syndrome.
  • •Be aware of the "AAS spectrum" which includes classic dissection, (IMH)—bleeding within the wall without a visible tear—and (PAU), which can progress to full dissection.
  • •Note the emerging association with pharmacological triggers, specifically fluoroquinolones, which may induce collagen degradation and increase the risk of aortic events within 30 days of exposure.

Evaluation

  • •Suspect aortic dissection in any patient presenting with sudden-onset, "tearing," "ripping," or "stabbing" chest or back pain that is maximal at its inception.
  • •Ask about pain migration, as the movement of pain from the chest to the back or abdomen often tracks the distal propagation of the dissection flap.
  • •Measure blood pressure in both arms simultaneously; a systolic blood pressure differential >20 mmHg is a classic sign of brachiocephalic or subclavian artery involvement.
  • •Perform a thorough four-limb pulse exam to identify pulse deficits, which occur when the false lumen compresses the true lumen or the flap occludes branch vessels.
  • •Auscultate for a new diastolic decrescendo murmur at the right sternal border, indicating acute due to aortic root dilation or leaflet prolapse.
  • •Screen for neurological deficits, including hemiparesis or altered mental status (carotid involvement) and paraplegia (spinal cord ischemia from intercostal artery involvement).
  • •Utilize the Aortic Dissection Detection Risk Score (ADD-RS) to categorize patients into low, intermediate, or high clinical suspicion based on predisposing factors and exam findings.
  • •Order a D-dimer test for patients with low clinical suspicion (ADD-RS ≤ 1); a value <500 ng/mL has a high negative predictive value and can effectively rule out the diagnosis.
  • •Obtain a 12-lead ECG to rule out primary , but remain vigilant as 10-20% of Type A dissections involve the coronary ostia (usually the RCA), causing ST-elevation.
  • •Order (CTA) of the chest, abdomen, and pelvis as the gold standard diagnostic test, providing nearly 99% sensitivity and specificity.
  • •Perform bedside Transthoracic Echocardiography (TTE) in unstable patients to rapidly screen for pericardial effusion, cardiac tamponade, or severe aortic root dilation.
  • •Consider Transesophageal Echocardiography (TEE) in the operating room or for patients with contraindications to CT contrast to visualize the intimal flap and valve function.

Management

  • •Initiate "anti-impulse therapy" immediately upon suspicion to reduce the rate of ventricular contraction (dP/dt) and systemic wall stress.
  • •Administer intravenous beta-blockers as first-line therapy; use Esmolol (500 mcg/kg bolus, then 50–200 mcg/kg/min) or Labetalol (20 mg IV bolus every 10 minutes) to achieve a target heart rate of ≤60 bpm.
  • •Ensure heart rate is controlled before adding vasodilators to prevent reflex tachycardia, which can accelerate dissection propagation.
  • •Target a systolic blood pressure between 100 and 120 mmHg; if BP remains elevated after beta-blockade, add Nitroprusside (0.25–10 mcg/kg/min) or Nicardipine (5–15 mg/hr).
  • •Consult Cardiac Surgery emergently for all Stanford Type A dissections; these are surgical emergencies requiring replacement of the ascending aorta to prevent tamponade or rupture.
  • •Transfer patients with Type A dissection to high-volume aortic centers, ideally using a "Direct-to-OR" protocol to bypass emergency department delays.
  • •Manage uncomplicated Stanford Type B dissections in an ICU setting with aggressive medical therapy (BP and HR control) and serial imaging.
  • •Perform (TEVAR) for "complicated" Type B dissections, defined by malperfusion, rupture, refractory pain, or rapid aortic expansion.
  • •Prioritize endovascular reperfusion (stenting) in stable patients with malperfusion syndrome (e.g., mesenteric ischemia) before proceeding to open aortic repair.
  • •Avoid the administration of thrombolytics or anticoagulants until dissection is definitively ruled out, as these agents can be fatal if a dissection is present.
  • •Monitor for acute kidney injury (AKI) and maintain adequate mean arterial pressure (MAP) to ensure spinal cord and visceral perfusion.
  • •Implement long-term blood pressure control with a target of <120/80 mmHg using beta-blockers as the backbone of therapy to reduce the risk of late aneurysmal expansion.
  • •Refer patients under age 60 for genetic counseling and screening of first-degree relatives to identify familial thoracic aortic aneurysm syndromes.
  • •Advise patients to avoid heavy isometric lifting (e.g., weightlifting) and fluoroquinolone antibiotics, which may increase the risk of future aortic events.

Board Review — High Yield

  • •Tearing/Ripping Pain — The classic description of pain that is maximal at onset, unlike the crescendo pain of MI.
  • •BP Differential — A difference of >20 mmHg between arms suggests the dissection involves the aortic arch/subclavian artery.
  • •Stanford Type A — Involves the ascending aorta; always a surgical emergency regardless of the entry tear location.
  • •Fluoroquinolones — Black box warning: avoid in patients with aortic disease due to increased risk of dissection/rupture.
  • •Cystic Medial Necrosis — The classic histopathological finding in the aortic media, especially in Marfan syndrome.
  • •D-dimer — Useful only for its high negative predictive value (NPV) to rule out dissection in low-risk patients.
  • •Beta-blockers before Vasodilators — Essential sequence to prevent reflex tachycardia and increased aortic wall shear stress.
  • •1% to 2% per hour — The mortality rate of untreated acute Type A aortic dissection in the first 24-48 hours.

Deep Dive — Evidence Details

References

  1. [1]

    Bin L, Fei J, Zhao L et al.. “Comparative effectiveness and safety of open triple-branched stent graft technique with stented elephant trunk implantation in treating Stanford type A aortic dissection: A trial sequential meta-analysis.” Journal of cardiac surgery (2022). PMID: 36352782 ↗

    L2aSR_OBSCited in: Definition, Synonyms, and Classification
  2. [2]

    Yamashita Y, Sicouri S, Dokollari A et al.. “Double arterial vs. single axillary cannulation in acute type A aortic dissections: a meta-analysis.” Future cardiology (2024). PMID: 38963122 ↗

    L2aSR_OBSCited in: Definition, Synonyms, and Classification
  3. [3]

    Yamashita Y, Sicouri S, Kjelstrom S et al.. “Direct aortic cannulation versus femoral arterial cannulation for early outcomes in acute type A aortic dissection: A study-level meta-analysis.” Perfusion (2025). PMID: 38537032 ↗

    L2aSR_OBSCited in: Definition, Synonyms, and Classification
  4. [4]

    Yamashita Y, Sicouri S, Dokollari A et al.. “Aortic versus axillary cannulation in acute type A aortic dissection repair: A meta-analysis.” Asian cardiovascular & thoracic annals (2024). PMID: 38343086 ↗

    L2aSR_OBSCited in: Definition, Synonyms, and Classification
  5. [5]

    Guglielmi V, Groeneveld NS, Posthuma L et al.. “Aortic dissection masquerading as a code stroke: A single-centre cohort study.” European stroke journal (2020). PMID: 32232170 ↗

    L2bCOHORTCited in: Definition, Synonyms, and Classification
  6. [6]

    Modares M, Hanneman K, Ouzounian M et al.. “Computed Tomography Angiography Assessment of Acute Aortic Syndromes: Classification, Differentiating Imaging Features, and Imaging Interpretation Pitfalls.” Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes (2022). PMID: 33874779 ↗

    L5REVIEW_NARRATIVECited in: Definition, Synonyms, and Classification
  7. [7]

    Zhu Y, Lingala B, Baiocchi M et al.. “Type A Aortic Dissection-Experience Over 5 Decades: JACC Historical Breakthroughs in Perspective.” Journal of the American College of Cardiology (2020). PMID: 33004136 ↗

    L5REVIEW_NARRATIVECited in: Definition, Synonyms, and Classification
  8. [8]

    Saremi F, Hassani C, Lin LM et al.. “Image Predictors of Treatment Outcome after Thoracic Aortic Dissection Repair.” Radiographics : a review publication of the Radiological Society of North America, Inc (2018). PMID: 30312138 ↗

    L5REVIEW_NARRATIVECited in: Definition, Synonyms, and Classification
  9. [9]

    Gutschow SE, Walker CM, Martínez-Jiménez S et al.. “Emerging Concepts in Intramural Hematoma Imaging.” Radiographics : a review publication of the Radiological Society of North America, Inc (2016). PMID: 27163587 ↗

    L5REVIEW_NARRATIVECited in: Definition, Synonyms, and Classification
  10. [10]

    Li S, Liu X, Yang J et al.. “Clinical features and survival analysis of non-hypertensive aortic dissection patients post-thoracic endovascular aortic repair: a 10-year retrospective study.” Journal of thoracic disease (2024). PMID: 39678834 ↗

    L2bCOHORTCited in: Definition, Synonyms, and Classification
  11. [11]

    Uriu Y, Kuriyama A. “Malperfusion-associated transient monoplegia as an initial manifestation of aortic dissection.” The American journal of emergency medicine (2021). PMID: 33036846 ↗

    L4CASE_REPORTCited in: Definition, Synonyms, and Classification
  12. [12]

    Ramesh P, Al-Zubaidi FI, Abdelghaffar M et al.. “TEM Classification of Aortic Dissection-The Evolving Scoring System: A Literature Review.” Heart, lung & circulation (2024). PMID: 38143192 ↗

    L5REVIEW_NARRATIVECited in: Definition, Synonyms, and Classification
  13. [13]

    Gao Y, Li D, Cao Y et al.. “Prognostic value of serum albumin for patients with acute aortic dissection: A retrospective cohort study.” Medicine (2019). PMID: 30732220 ↗

    L2bCOHORTCited in: Definition, Synonyms, and Classification
  14. [14]

    Abarca Rozas BA, Schwarze Fieldhouse MW, Contreras Bertolo RI et al.. “Atypical presentation and late diagnosis of acute aortic dissection without timely surgical treatment: case report and literature review.” Medwave (2018). PMID: 30240389 ↗

    L4CASE_REPORTCited in: Definition, Synonyms, and Classification
  15. [15]

    Wu Z, Yuan Y, Chai C et al.. “Impact of the society for vascular surgery/society of thoracic surgeons classification on prognosis and therapeutic strategies in acute Stanford type A aortic dissection.” Frontiers in cardiovascular medicine (2026). PMID: 41953671 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  16. [16]

    Shirakura K, Ushioda R, Kunioka S et al.. “Association of Stanford, DeBakey classification and false-lumen blood flow with age of onset in acute aortic dissection.” Frontiers in cardiovascular medicine (2026). PMID: 41859548 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  17. [17]

    Xu Y, Huang C, Huang C et al.. “Analysis of epidemiological characteristics and prognosis based on 1,343 cases of aortic dissection from a regional single center.” Frontiers in cardiovascular medicine (2026). PMID: 41725939 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  18. [18]

    Canalejo-Codina F, López-Lluva MT, Rumoroso JR et al.. “Epidemiology, treatment, and data management trends in aortic dissection and related syndromes: Insights and limitations from the RAE-CMBD in Spain (2016-2021).” Progress in cardiovascular diseases (2025). PMID: 41448445 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  19. [19]

    Ikeno Y, Tanaka A, Troncone MJ et al.. “Impact of new classification from the Society for Vascular Surgery and Society of Thoracic Surgeons on acute Stanford type A aortic dissection.” Journal of vascular surgery (2025). PMID: 40692091 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  20. [20]

    Zhang J, Han L, Liu H et al.. “Metabolomic analysis reveals the metabolic disturbance in aortic dissection: Subtype difference and accurate diagnosis.” Nutrition, metabolism, and cardiovascular diseases : NMCD (2023). PMID: 37263915 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  21. [21]

    Huang LT, Tsai YS, Liou CF et al.. “Automated Stanford classification of aortic dissection using a 2-step hierarchical neural network at computed tomography angiography.” European radiology (2022). PMID: 34854930 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  22. [22]

    Xu W, Mani K, Khashram M. “Ethnic differences in incidence and outcomes of acute aortic syndromes in the Midland region of New Zealand.” Journal of vascular surgery (2022). PMID: 34506891 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  23. [23]

    Ge YY, Rong D, Ge XH et al.. “The 301 Classification: A Proposed Modification to the Stanford Type B Aortic Dissection Classification for Thoracic Endovascular Aortic Repair Prognostication.” Mayo Clinic proceedings (2020). PMID: 32622443 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  24. [24]

    Pan E, Gudbjartsson T, Ahlsson A et al.. “Low rate of reoperations after acute type A aortic dissection repair from The Nordic Consortium Registry.” The Journal of thoracic and cardiovascular surgery (2018). PMID: 29753501 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  25. [25]

    Platon A, Bernard S, Perrin N et al.. “Type A aortic dissection: Are there CT signs suggestive of valvular involvement?” European journal of radiology (2016). PMID: 27776642 ↗

    L5OTHERCited in: Definition, Synonyms, and Classification
  26. [26]

    Xue J, Ni Y, He J et al.. “A case of twin pregnancy with "precious fetuses" complicated by DeBakey type I aortic dissection.” Journal of cardiothoracic surgery (2025). PMID: 41126334 ↗

    L4CASE_REPORTCited in: Definition, Synonyms, and Classification
  27. [27]

    Varela-Jaramillo S, Taub-Krivoy A, Gómez-Gutiérrez MA et al.. “Neurological Manifestations of Aortic Dissection: A Scoping Review.” Journal of acute medicine (2024). PMID: 39624147 ↗

    L5REVIEW_NARRATIVECited in: Definition, Synonyms, and Classification
  28. [28]

    Gao ZC, Wang Y, Li GS et al.. “[Risk factors for adverse prognosis in acute aortic syndrome: a single-center retrospective cohort study].” Zhonghua xin xue guan bing za zhi (2025). PMID: 39965848 ↗

    L2bCOHORTCited in: Definition, Synonyms, and Classification
  29. [29]

    Nakajima T, Shibata T, Mukawa K et al.. “Treatment Strategies for Acute Aortic Dissection With Malperfusion: A Retrospective Study.” Cureus (2024). PMID: 39219975 ↗

    L2bCOHORTCited in: Definition, Synonyms, and Classification
  30. [30]

    MacKerricher W, Klein RR, Winston DC. “Association of Antemortem Central Nervous System Symptoms and Location of Aortic Dissections; A Retrospective Study from 2001-2014.” Academic forensic pathology (2016). PMID: 31239925 ↗

    L2bCOHORTCited in: Definition, Synonyms, and Classification
  31. [31]

    Han Z, Li B, Liu J. “Predictive value of machine learning for mortality risk in aortic dissection: a systematic review and meta-analysis.” International journal of medical informatics (2026). PMID: 41539126 ↗

    L2aSR_OBSCited in: Etiology and Triggering Factors
  32. [32]

    Sharma S, Seth J, Rabkin SW. “Hypertension in Thoracic Aortic Dissection: A Meta-Analysis-Based Consideration in the Choice of Antihypertensive Agents.” American journal of hypertension (2026). PMID: 41206434 ↗

    L2aSR_OBSCited in: Etiology and Triggering Factors, Pathophysiology, History and Physical Examination
  33. [33]

    Chen Q, Jiang Y, Shen Y et al.. “Risk of aortic aneurysm/aortic dissection associated with fluoroquinolones use: A meta-analysis of cohort studies.” Vascular (2026). PMID: 41678806 ↗

    L2aSR_OBSCited in: Etiology and Triggering Factors
  34. [34]

    Squizzato F, Bilato MJ, Menegolo M et al.. “A Systematic Review and Meta-Analysis on the Outcomes of Distal Aortic Interventions for Residual Aortic Dissection.” Annals of vascular surgery (2026). PMID: 41106673 ↗

    L2aSR_OBSCited in: Etiology and Triggering Factors
  35. [35]

    Peng Z, Liang S, Zhang R et al.. “Left Subclavian Artery Revascularization With In Situ Laser Fenestration During Thoracic Endovascular Aortic Repair for Acute Complicated or High-Risk Type B Aortic Dissection: Results of the LLTEVAR Trial.” Journal of the American Heart Association (2025). PMID: 41368828 ↗

    L2bTRIAL_NONRANDOMCited in: Etiology and Triggering Factors, Clinical Features and Variants, Differential Diagnosis, Supportive Care and Complication Management
  36. [36]

    Wu ZY, Yang Y, Li ZL et al.. “Effects of Fluoroquinolones on Aortic Aneurysm or Dissection Processes: A Systematic Review and Meta-Analysis.” Reviews in cardiovascular medicine (2026). PMID: 41923717 ↗

    L2aSR_OBSCited in: Etiology and Triggering Factors
  37. [37]

    Kaewboonlert N, Pongsuwan N, Chatkaewpaisal C et al.. “Survival outcomes of hybrid versus total arch replacement in type A aortic dissection: A meta-analysis of reconstructed individual participant data.” Asian cardiovascular & thoracic annals (2026). PMID: 41236863 ↗

    L2aSR_OBSCited in: Etiology and Triggering Factors, Supportive Care and Complication Management
  38. [38]

    Petersen CS, Karon Z, Obel LM et al.. “Aortic and Iliac Calcifications as Predictors of Aortic Dissection, Aneurysm Rupture, and Peripheral Vascular Disease: A Prospective Cohort Study from the DANCAVAS Trials.” Circulation (2026). PMID: 41766556 ↗

    L2bCOHORTCited in: Etiology and Triggering Factors
  39. [39]

    Shao Z, Lu Z, Duan W et al.. “Insulin resistance indicators in aortic disease: A large cohort study.” Clinical and translational medicine (2026). PMID: 41499559 ↗

    L2bCOHORTCited in: Etiology and Triggering Factors
  40. [40]

    Bashir M, Jubouri M, Surkhi AO et al.. “From Equipoise to Evidence: Pre-Trial Setup of the European Uncomplicated Type B Aortic Repair Clinical Trial.” Annals of vascular surgery (2026). PMID: 41421577 ↗

    L2bTRIAL_NONRANDOMCited in: Etiology and Triggering Factors, Supportive Care and Complication Management
  41. [41]

    Yan M, Wang K, Liu S et al.. “Factors associated with device-associated health care-associated infections after cardiac surgery: a matched cohort study.” PeerJ (2026). PMID: 41978887 ↗

    L2bCOHORTCited in: Etiology and Triggering Factors
  42. [42]

    Imbriani M, Marchesini D, Piras GN et al.. “Mucoid extracellular matrix accumulation as a histopathological marker of aortic fragility: Two autopsy cases and a literature review.” Legal medicine (Tokyo, Japan) (2026). PMID: 41525745 ↗

    L4CASE_REPORTCited in: Etiology and Triggering Factors
  43. [43]

    Pruna-Guillen R, Rojanathagoon T, Oo A et al.. “Impact of an On-Call Specialist Aortic Rota Implementation in Acute Type a Aortic Dissection on Outcomes and Repair Complexity: A Retrospective Cohort Study.” Interdisciplinary cardiovascular and thoracic surgery (2025). PMID: 41148058 ↗

    L2bCOHORTCited in: Etiology and Triggering Factors, Supportive Care and Complication Management
  44. [44]

    Li C, Liu C. “Multimodal imaging of acquired aortic diseases: clinical efficacy, comparative analysis, and future perspectives.” The international journal of cardiovascular imaging (2026). PMID: 41549183 ↗

    L5REVIEW_NARRATIVECited in: Etiology and Triggering Factors, Clinical Features and Variants
  45. [45]

    Pan C, Ning S, Zhou Y et al.. “Influencing Factors of Postoperative Mechanical Ventilation Weaning Outcomes in Acute Stanford Type A Aortic Dissection: A Single-Center Retrospective Study.” British journal of hospital medicine (London, England : 2005) (2025). PMID: 41134180 ↗

    L2bCOHORTCited in: Etiology and Triggering Factors, Supportive Care and Complication Management
  46. [46]

    Ram E, Lau C, Gregg A et al.. “Comparative Analysis of Risk Profile and Treatment Outcomes in Patients with Thoracoabdominal Aortic Aneurysm: Chronic Dissection Versus Degenerative Disease.” European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery (2026). PMID: 41904662 ↗

    L5OTHERCited in: Etiology and Triggering Factors, Supportive Care and Complication Management
  47. [47]

    Li S, Li W, Zhang J et al.. “Association between atherosclerotic index of plasma and long-term aortic-related adverse events in type B aortic dissection patients undergoing thoracic endovascular aortic repair.” Cardiovascular diabetology (2026). PMID: 41787449 ↗

    L5OTHERCited in: Etiology and Triggering Factors, Management
  48. [48]

    Jackson E, Carbone A, Shalhub S et al.. “Sex-Related Differences in Clinical Profile, Management, and Outcomes of Patients With Type A and B Acute Aortic Dissection: Observations From IRAD.” Journal of the American Heart Association (2026). PMID: 41744110 ↗

    L5OTHERCited in: Etiology and Triggering Factors, Management, Landmark Trials and Key Evidence
  49. [49]

    Dell'Aquila AM, Georgevici AI, Wisniewski K et al.. “Risk Profile and Outcomes of Patients Requiring Coronary Revascularization as Concomitant Procedure to Repair of Type A Aortic Dissection.” The Annals of thoracic surgery (2026). PMID: 41563923 ↗

    L5OTHERCited in: Etiology and Triggering Factors, Pathophysiology
  50. [50]

    Gomez A, Carroway W, Tu S et al.. “Ascending Thoracic Aortic Aneurysms in a Veterans Affairs Health System: Longitudinal Outcomes and Risk Factors.” Journal of the American Heart Association (2026). PMID: 41532501 ↗

    L5OTHERCited in: Etiology and Triggering Factors
  51. [51]

    Tang C, Wang T, Diao H et al.. “Development and validation of a predictive model for postoperative acute respiratory distress syndrome in patients with type A aortic dissection based on the 2023 updated definition.” Respiratory research (2025). PMID: 41388298 ↗

    L5OTHERCited in: Etiology and Triggering Factors, Supportive Care and Complication Management
  52. [52]

    Abusafia M, Jadam S, Kalahasti V et al.. “Sex-Based Differences in Long-Term Outcomes of Patients With Ascending Aortic Dilation.” Journal of the American Heart Association (2025). PMID: 41334743 ↗

    L5OTHERCited in: Etiology and Triggering Factors
  53. [53]

    Maznyczka A, Gill C, Norman S et al.. “Outcomes of Non-Anesthetist Led Conscious Sedation for 2000 Transcatheter Aortic Valve Implantations.” Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2026). PMID: 41332125 ↗

    L5OTHERCited in: Etiology and Triggering Factors, Supportive Care and Complication Management
  54. [54]

    Gober LM, Telma K, Richmond E et al.. “Protocolized management of acute type B aortic dissections reduces disease progression and need for surgery.” Journal of vascular surgery (2026). PMID: 41317972 ↗

    L5OTHERCited in: Etiology and Triggering Factors, Clinical Features and Variants
  55. [55]

    Frumkin D, Nersesian G, Spethmann S et al.. “Acute type A aortic dissection following TAVI.” International journal of cardiology (2026). PMID: 41276188 ↗

    L5OTHERCited in: Etiology and Triggering Factors, Supportive Care and Complication Management
  56. [56]

    Yokota A, Kabutoya T, Hoshide S et al.. “Digital electrocardiogram-measured P-wave duration and hypertensive heart disease are associated with cardiovascular events in patients with cardiovascular risks.” Hypertension research : official journal of the Japanese Society of Hypertension (2026). PMID: 41272126 ↗

    L5OTHERCited in: Etiology and Triggering Factors
  57. [57]

    Kabutoya T, Hoshide S, Kario K. “Digital ECG detection of flat T waves predicts cardiovascular events in high-risk patients: the Coupling Study.” Hypertension research : official journal of the Japanese Society of Hypertension (2026). PMID: 41272124 ↗

    L5OTHERCited in: Etiology and Triggering Factors, Differential Diagnosis
  58. [58]

    Chamseddine H, Halabi M, Hamdan H et al.. “The impact of intervention timing, etiology, and revascularization strategy on acute mesenteric ischemia outcomes.” Journal of vascular surgery (2026). PMID: 41242625 ↗

    L5OTHERCited in: Etiology and Triggering Factors
  59. [59]

    Nadel J, Suinesiaputra A, Paratz ED et al.. “Site-Specific Analysis of Thoracic Aortic Aneurysm and Cardiovascular Mortality: Insights From the National Echo Database Australia.” Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography (2026). PMID: 41242620 ↗

    L5OTHERCited in: Etiology and Triggering Factors
  60. [60]

    Kletzer J, van Kampen A, Peterss S et al.. “Weathering the Aorta: The Impact of Environmental Factors on Acute Aortic Dissection.” European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery (2025). PMID: 41223150 ↗

    L5OTHERCited in: Etiology and Triggering Factors
  61. [61]

    Liu G, Wang D, Yang Y et al.. “Efficacy and Safety of preoperative Controlling Heart Rate in Patients with Acute Type A Aortic Dissection (ESCORT): protocol for a randomised controlled trial.” BMJ open (2026). PMID: 41962972 ↗

    L2bTRIAL_NONRANDOMCited in: Pathophysiology, History and Physical Examination, Management
  62. [62]

    Chen X, Xie W, Li W et al.. “Cerebral Oximetry Index-Guided Blood Pressure Management During Cardiopulmonary Bypass Reduces Postoperative Delirium in Patients with Acute Type A Aortic Dissection.” Journal of cardiothoracic and vascular anesthesia (2025). PMID: 39855957 ↗

    L1bRCTCited in: Pathophysiology, History and Physical Examination
  63. [63]

    Naito N, Takagi H. “Thoracic endovascular aortic repair for retrograde type a intramural hematoma or aortic dissection with intimal disruption in the descending aorta: Systematic review and meta-analysis.” Perfusion (2025). PMID: 39977541 ↗

    L2aSR_OBSCited in: Pathophysiology
  64. [64]

    Hochberg CH, Yan L, Card ME et al.. “Outcomes of patients with hypertensive emergency managed in intensive vs intermediate care settings: a multihospital retrospective cohort study.” Annals of the American Thoracic Society (2026). PMID: 41915559 ↗

    L2bCOHORTCited in: Pathophysiology, History and Physical Examination, Management
  65. [65]

    Song T, Han Y, Xie L et al.. “Cellular Heterogeneity in Aortic Aneurysm and Dissection: Molecular Mechanisms and Therapeutic Opportunities.” Circulation research (2026). PMID: 41886549 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology
  66. [66]

    Hu M, Chen B, Luo Y. “Computational fluid dynamics modelling of hemodynamics in aortic aneurysm and dissection: a review.” Frontiers in bioengineering and biotechnology (2025). PMID: 40190707 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology
  67. [67]

    Jia Q, Bian Y, Wang X et al.. “Case Report: Diagnostic pitfalls in localized aortic root dissection: two cases and a literature review.” Frontiers in cardiovascular medicine (2026). PMID: 41953663 ↗

    L4CASE_REPORTCited in: Pathophysiology
  68. [68]

    Cosco V, Grenci G, Fiorentino A et al.. “Limited Iatrogenic Dissection of the Aortic Root: To Treat or Not to Treat?” Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2025). PMID: 41078216 ↗

    L4CASE_REPORTCited in: Pathophysiology, Clinical Features and Variants
  69. [69]

    Kelly JJ, Brown CR, Eisenga JB et al.. “Repair of Arch Aneurysm With Frozen Elephant Trunk for DeBakey Type I Dissection Previously Treated With a Hybrid Arch Bare-Metal Stent.” The Annals of thoracic surgery (2025). PMID: 40609665 ↗

    L4CASE_REPORTCited in: Pathophysiology
  70. [70]

    Cui P, Sun HH, Luo Y et al.. “Aortic dissection: the role of macrophages in disease pathogenesis and their potential as a treatment target.” Journal of cardiothoracic surgery (2026). PMID: 41765885 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology
  71. [71]

    Bissell MM, Garg P. “Clinical 4D flow MRI assessment in aortopathy-what the clinician needs to know.” Cardiovascular diagnosis and therapy (2025). PMID: 41509618 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology
  72. [72]

    Clothier JS, Kobsa S. “Management of Acute Type A Aortic Dissection.” Cardiology clinics (2025). PMID: 40268355 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology
  73. [73]

    Ahmad HM, Iskandar Z, Lang CC et al.. “Emerging imaging and circulating biomarkers in relation to underlying mechanisms in Bicuspid Aortic Valve aortopathy.” International journal of cardiology. Heart & vasculature (2025). PMID: 40130209 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology
  74. [74]

    Murtada A, Jubouri M, Refaie M et al.. “Nonocclusive Mesenteric Ischemia in Aortic Surgery: What You Need to Know.” Annals of vascular surgery (2025). PMID: 39863280 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology
  75. [75]

    Al-Rawi M, Lim ETA, Khashram M et al.. “Utility of Computational Modeling in Reassessing the Threshold for Intervention and Progression into Type A Aortic Dissection.” Biomedicines (2026). PMID: 41898340 ↗

    L5OTHERCited in: Pathophysiology
  76. [76]

    Li B, Zhu Y, Wang K et al.. “Strongly coupled fluid-structure interaction analysis of TEVAR with double-branched endograft for non-A non-B aortic dissection: a patient-specific case study.” Journal of biomechanics (2026). PMID: 41391440 ↗

    L5OTHERCited in: Pathophysiology
  77. [77]

    Liu W, Lin Q, Zhong H et al.. “Microbiomics and metabolomics explored the characteristics of gut microbiota and metabolites in patients with aortic dissection.” Frontiers in cellular and infection microbiology (2025). PMID: 41132489 ↗

    L5OTHERCited in: Pathophysiology, History and Physical Examination
  78. [78]

    Kario K, Okawara Y, Kanegae H et al.. “Relationship Between Home Blood Pressure Monitoring-Confirmed Resistant Hypertension and Cardiovascular Prognosis.” Hypertension (Dallas, Tex. : 1979) (2025). PMID: 41127912 ↗

    L5OTHERCited in: Pathophysiology, History and Physical Examination
  79. [79]

    Osswald A, Tsagakis K, Thielmann M et al.. “Can computational fluid dynamics simulations predict a distal stent graft-induced new entry after frozen elephant trunk operation?” Frontiers in cardiovascular medicine (2025). PMID: 41112231 ↗

    L5OTHERCited in: Pathophysiology
  80. [80]

    Kario K, Nishiyama A, Shibata S et al.. “The JSH Morning Hypertension Eradication Program Project.” Hypertension research : official journal of the Japanese Society of Hypertension (2025). PMID: 40858749 ↗

    L5OTHERCited in: Pathophysiology, History and Physical Examination, Differential Diagnosis
  81. [81]

    Wu T, Zhu H, Zhuo H et al.. “Fluid-structure interaction study of penetrating atherosclerotic ulcers: Assessing progression and rupture risks.” Computer methods and programs in biomedicine (2025). PMID: 40706491 ↗

    L5OTHERCited in: Pathophysiology, History and Physical Examination, Clinical Features and Variants
  82. [82]

    Zhang L, Yang S, Guo X et al.. “Changes in True and False Lumen Pressures During Closure of the Primary Tear in Aortic Dissection.” Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2025). PMID: 40665556 ↗

    L5OTHERCited in: Pathophysiology, History and Physical Examination
  83. [83]

    Chen Y, Guo J, Wang S et al.. “Identifying Hemodynamic Predictors of Aortic Growth After Thoracic Endovascular Aortic Repair for Type B Aortic Dissection.” Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists (2025). PMID: 40650600 ↗

    L5OTHERCited in: Pathophysiology
  84. [84]

    Larsen KSR, Tang M, Budtz-Lilly JW et al.. “Evaluation of a Rehabilitation Program With Blood Pressure-Guided Exercise Intensity Restrictions for Patients With Thoracic Aortic Dissection or Aneurysm.” Journal of cardiopulmonary rehabilitation and prevention (Unknown). PMID: 40627738 ↗

    L5OTHERCited in: Pathophysiology, History and Physical Examination
  85. [85]

    Chen N, Downing JV, Epstein J et al.. “Emergency Department Blood Pressure Management in Type B Aortic Dissection: An Analysis with Machine Learning.” The western journal of emergency medicine (2025). PMID: 40561988 ↗

    L5OTHERCited in: Pathophysiology, History and Physical Examination
  86. [86]

    Öster H, Chen T, Mennander A et al.. “CMKLR-1 Expression in Human Aorta Is Dominated by Smooth Muscle Cell Positivity.” The journal of histochemistry and cytochemistry : official journal of the Histochemistry Society (2025). PMID: 40552467 ↗

    L5OTHERCited in: Pathophysiology
  87. [87]

    Chen X, Xie L, Wu Q et al.. “Development and validation of a novel prognostic score to improve prognostic prediction in patients with type B aortic dissection.” Journal of vascular surgery (2025). PMID: 40541619 ↗

    L5OTHERCited in: Pathophysiology
  88. [88]

    Balasubramanya A, Gheysen L, Wagenhäuser MU et al.. “Hemodynamics in aortic dissections: A fluid-solid interaction study in an idealized dissection model with a false lumen side branch.” Journal of biomechanics (2025). PMID: 40449253 ↗

    L5OTHERCited in: Pathophysiology
  89. [89]

    Wang X, Song F, Jiang L et al.. “Efficacy and Safety of Sacubitril/Valsartan in Chronic Type B Aortic Dissection Combined With Mild Hypertension.” American journal of hypertension (2024). PMID: 38564196 ↗

    L1bRCTCited in: History and Physical Examination
  90. [90]

    Zhu YL, Wang S, Gu Y et al.. “Efficacy of predictive pain intervention in patients with aortic dissection.” Technology and health care : official journal of the European Society for Engineering and Medicine (2024). PMID: 38943408 ↗

    L1bRCTCited in: History and Physical Examination
  91. [91]

    Song W, Liu J, Tu G et al.. “Impact of body mass index on perioperative mortality of acute stanford type A aortic dissection: a systematic review and meta-analysis.” BMC cardiovascular disorders (2023). PMID: 37907847 ↗

    L2aSR_OBSCited in: History and Physical Examination
  92. [92]

    Xiao Y, Huang S, Zheng D et al.. “Delayed Diagnosis of Aortic Dissection: A Scoping Review.” Reviews in cardiovascular medicine (2025). PMID: 40630449 ↗

    L2aSR_OBSCited in: History and Physical Examination
  93. [93]

    Oztas DM, Ozdemir E, Bauernschmitt R et al.. “Transcatheter aortic valve implantation for pure aortic insufficiency in a patient following David-type aortic valve-sparing root replacement after aortic dissection-A successful off-label procedure.” Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2024). PMID: 38577923 ↗

    L4CASE_REPORTCited in: History and Physical Examination
  94. [94]

    Gillinov LA, Kapoor SR, Sperry AE et al.. “Fate of the Aortic Root After Reconstruction With Felt Neomedia for Acute Type A Aortic Dissection.” European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery (2026). PMID: 41557464 ↗

    L5OTHERCited in: History and Physical Examination
  95. [95]

    Zhao R, Liu Y, Zhang B et al.. “Concomitant Aortic Root Replacement in Total Arch Replacement With Frozen Elephant Trunk for Type A Aortic Dissection: A Propensity-Weighted Analysis.” European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery (2026). PMID: 41410509 ↗

    L5OTHERCited in: History and Physical Examination, Supportive Care and Complication Management
  96. [96]

    Wagner CM, Marway PS, Ferrel MN et al.. “Sex differences in ascending aortic diameter at the time of acute type A aortic dissection.” Heart (British Cardiac Society) (2026). PMID: 41083213 ↗

    L5OTHERCited in: History and Physical Examination
  97. [97]

    Ikeno Y, Tanaka A, Estrera GA et al.. “Aortic Root Reconstruction With Pledgeted Sutures in Patients With Acute Type A Aortic Dissection.” The Annals of thoracic surgery (2026). PMID: 40681029 ↗

    L5OTHERCited in: History and Physical Examination
  98. [98]

    Norton EL, Arora A, Cangut B et al.. “Association of intraoperative transfusion of blood products with postoperative outcomes and midterm survival in acute type A aortic dissection repair.” JTCVS open (2025). PMID: 40061521 ↗

    L5OTHERCited in: History and Physical Examination
  99. [99]

    Ho CH, Lin CP, Chang FC et al.. “Blood Pressure and Heart Rate Management in Patients After Repair of Type A Aortic Dissection.” The Annals of thoracic surgery (2025). PMID: 40057152 ↗

    L5OTHERCited in: History and Physical Examination
  100. [100]

    Jiang B, Ren P, He C et al.. “Short-term disruption of TGF-β signaling in adult mice renders the aorta vulnerable to hypertension-induced dissection.” JCI insight (2025). PMID: 39932797 ↗

    L5OTHERCited in: History and Physical Examination
  101. [101]

    Chen D, Fang K, Luo M et al.. “Aortic Dissection Incidence and Risk Factor Analysis: Findings from the China Kadoorie Biobank.” European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery (2025). PMID: 39643204 ↗

    L5OTHERCited in: History and Physical Examination
  102. [102]

    Leshnower BG, Farrington WJ, Huckaby LV et al.. “Long-term Results of Valve-Sparing Aortic Root Replacement in Acute Type A Aortic Dissection.” The Annals of thoracic surgery (2025). PMID: 39293750 ↗

    L5OTHERCited in: History and Physical Examination
  103. [103]

    Kario K, Okawara Y, Kanegae H et al.. “Peak nocturnal home blood pressure as an early and strong novel risk factor for stroke: the practitioner-based nationwide J-HOP Nocturnal BP study.” Hypertension research : official journal of the Japanese Society of Hypertension (2025). PMID: 39242824 ↗

    L5OTHERCited in: History and Physical Examination
  104. [104]

    Zhang K, Zhou C, Gao S et al.. “The optimal degree of core temperature for hypothermic circulatory arrest in complex aortic arch surgery: results from 1310 patients.” European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery (2024). PMID: 39137134 ↗

    L5OTHERCited in: History and Physical Examination
  105. [105]

    Kario K, Kanegae H, Okawara Y et al.. “Home Blood Pressure Variability Risk Prediction Score for Cardiovascular Disease Using Data From the J-HOP Study.” Hypertension (Dallas, Tex. : 1979) (2024). PMID: 39136129 ↗

    L5OTHERCited in: History and Physical Examination
  106. [106]

    Elbatarny M, Trimarchi S, Korach A et al.. “Axillary vs Femoral Arterial Cannulation in Acute Type A Dissection: International Multicenter Data.” The Annals of thoracic surgery (2024). PMID: 38458510 ↗

    L5OTHERCited in: History and Physical Examination, Landmark Trials and Key Evidence
  107. [107]

    Ahmad RA, Orelaru F, Arora A et al.. “Acute type A intramural hematoma: The less-deadly acute aortic syndrome?” The Journal of thoracic and cardiovascular surgery (2025). PMID: 38280668 ↗

    L5OTHERCited in: History and Physical Examination
  108. [108]

    Ripley B, Scheidt MJ, Aghayev A et al.. “ACR Appropriateness Criteria® Thoracic Aortic Aneurysm or Dissection-Treatment Planning and Follow-Up: 2024 Update.” Journal of the American College of Radiology : JACR (2025). PMID: 40409894 ↗

    L1cGUIDELINECited in: Clinical Features and Variants, Guidelines and Resources
  109. [109]

    Esfahanian F, Madani MH. “Clinical and Imaging Features of Aortic Penetrating Atherosclerotic Ulcers: A Systematic Review and Meta-Analysis.” Journal of clinical medicine (2026). PMID: 41682880 ↗

    L2aSR_OBSCited in: Clinical Features and Variants, Management
  110. [110]

    Goodacre S, Pandor A, Thokala P et al.. “Diagnostic strategies for suspected acute aortic syndrome: systematic review, meta-analysis, decision-analytic modelling and value of information analysis.” Health technology assessment (Winchester, England) (2025). PMID: 40944621 ↗

    L2aSR_OBSCited in: Clinical Features and Variants
  111. [111]

    Anezaki H, Aoki Y, Kato H et al.. “Perioperative cardiac arrest requiring admission to intensive care units in Japan: epidemiological differences between emergency and elective surgery from a multicentre cohort study.” British journal of anaesthesia (2025). PMID: 40713194 ↗

    L2bCOHORTCited in: Clinical Features and Variants
  112. [112]

    Yao YT, Xie CM, Wang HB et al.. “Acute type A aortic dissection patients undergoing surgical repair during the COVID-19 pandemic.” Medicine (2025). PMID: 40295228 ↗

    L2aSR_OBSCited in: Clinical Features and Variants
  113. [113]

    Yang KJ, Chi NH, Yu HY et al.. “Endovascular vs. open surgical repair in retrograde type a dissection & intramural hematoma: A study-level meta-analysis.” Interdisciplinary cardiovascular and thoracic surgery (2025). PMID: 40991360 ↗

    L2aSR_OBSCited in: Clinical Features and Variants
  114. [114]

    Ayhan C, Mekhaeil M, Channawi R et al.. “Applications of Artificial Intelligence as a Prognostic Tool in the Management of Acute Aortic Syndrome and Aneurysm: A Comprehensive Review.” Journal of clinical medicine (2025). PMID: 41375721 ↗

    L5REVIEW_NARRATIVECited in: Clinical Features and Variants
  115. [115]

    Kamel S, Chastant R, Alric P et al.. “Single- and Double-Fenestrated Physician-Modified Stent Grafts for Emergent Aortic Arch Lesions.” Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists (2025). PMID: 41200840 ↗

    L5REVIEW_NARRATIVECited in: Clinical Features and Variants
  116. [116]

    Chochoł P, Witt-Majchrzak A, Mycko MP. “Dissected Thoracic Aorta Masked as Seizures: A Case Report.” Journal of clinical medicine (2026). PMID: 41682827 ↗

    L4CASE_REPORTCited in: Clinical Features and Variants
  117. [117]

    Pignataro G, Scafetta A, De Luca D et al.. “The Role of Biomarkers and Clinical Prediction Tools in the Diagnosis of Acute Aortic Syndromes: A Literature-Based Review.” Medicina (Kaunas, Lithuania) (2025). PMID: 41010942 ↗

    L5REVIEW_NARRATIVECited in: Clinical Features and Variants
  118. [118]

    Rahman I, Ali J, De Silva R. “Cannulation Strategies for Aortic Arch Surgery.” Journal of cardiovascular development and disease (2025). PMID: 41002639 ↗

    L5REVIEW_NARRATIVECited in: Clinical Features and Variants
  119. [119]

    Garg I, Grist TM, Nagpal P. “MR Angiography for Aortic Diseases.” Cardiology clinics (2025). PMID: 40268353 ↗

    L5REVIEW_NARRATIVECited in: Clinical Features and Variants
  120. [120]

    Sica G, Rea G, Lieto R et al.. “CT diagnosis and destiny of acute aortic intramural hematoma.” Frontiers in radiology (2025). PMID: 40134989 ↗

    L5REVIEW_NARRATIVECited in: Clinical Features and Variants
  121. [121]

    Cai Z, Yan T, Wang H et al.. “Impact of an emergency department bypass referral pathway for surgically managed Type A aortic dissection diagnosed at non-aortic centers.” Frontiers in public health (2025). PMID: 41924021 ↗

    L5OTHERCited in: Clinical Features and Variants, Management
  122. [122]

    Apostolidis G, Nana P, Panuccio G et al.. “A Retrospective Analysis of Barb-mediated Active Fixation Impact on Thoracic Endovascular Aortic Repair Outcomes.” Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists (2026). PMID: 41857800 ↗

    L5OTHERCited in: Clinical Features and Variants, Management
  123. [123]

    Bhat S, Bhat S, Schreve F et al.. “d-Dimer With the Aortic Dissection Detection Risk Score May Improve Patient Selection for Acute Aortic Syndrome Diagnostic Imaging.” Emergency medicine Australasia : EMA (2026). PMID: 41582603 ↗

    L5OTHERCited in: Clinical Features and Variants
  124. [124]

    Meinert ÉFRC, Kremer J, Farag M et al.. “Outcomes of total arch replacement and frozen elephant trunk in acute aortic syndrome.” Frontiers in cardiovascular medicine (2025). PMID: 41552679 ↗

    L5OTHERCited in: Clinical Features and Variants, Supportive Care and Complication Management
  125. [125]

    Yang J, Zhang X, Lou D et al.. “First in Human Evaluation of an Innovative Stent Graft for Endovascular Repair of Acute Ascending Aortic Syndromes.” European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery (2025). PMID: 41391565 ↗

    L5OTHERCited in: Clinical Features and Variants, Differential Diagnosis
  126. [126]

    Keyoumu R, Wang Y, Liu R et al.. “Three Dimensional Printing Assisted Multi-fenestrated Endovascular Repair of the Aortic Arch: A Multicentre Study.” European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery (2025). PMID: 41380763 ↗

    L5OTHERCited in: Clinical Features and Variants
  127. [127]

    Schönbeck H, Björkelund A, Møller ES et al.. “A missed diagnosis of acute aortic syndrome is associated with ischaemic ECG changes and an initial suspicion of myocardial infarction: a retrospective observational study.” BMC emergency medicine (2025). PMID: 41315990 ↗

    L5OTHERCited in: Clinical Features and Variants, Differential Diagnosis
  128. [128]

    Xu W, Haran C, Lim E et al.. “Nationwide outcomes of early thoracic endovascular aortic repair for type B aortic dissection.” Journal of vascular surgery (2026). PMID: 41177275 ↗

    L5OTHERCited in: Clinical Features and Variants, Supportive Care and Complication Management
  129. [129]

    Besola L, Biasci L, Mangifesta C et al.. “Warming up the frozen elephant trunk for aortic arch pathology.” Annals of cardiothoracic surgery (2025). PMID: 41098994 ↗

    L5OTHERCited in: Clinical Features and Variants
  130. [130]

    Voetsch A, Gottardi R, Winkler A et al.. “Frozen Elephant Trunk in Acute Aortic Syndrome: Retrospective Results from a Low-Volume Center.” Journal of clinical medicine (2025). PMID: 41095777 ↗

    L5OTHERCited in: Clinical Features and Variants
  131. [131]

    Ullery BW, Alie-Cusson F, Magee GA et al.. “Laser in situ fenestrated endograft (LIFE) repair of complex aortic arch pathology: Early outcomes from the multicenter LIFE registry.” Journal of vascular surgery (2026). PMID: 41075877 ↗

    L5OTHERCited in: Clinical Features and Variants
  132. [132]

    Francesco Squizzato, D'Oria M, Antonello M et al.. “Editor's Choice - International Expert Consensus on the Management of Acute Aortic Type B Intramural Haematoma and Penetrating Ulcer.” European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery (2026). PMID: 41038380 ↗

    L5OTHERCited in: Clinical Features and Variants
  133. [133]

    Cui D, Li X, Chen Y et al.. “Risk Factor Analysis of Post-TEVAR Distal Aortic Expansion: A Systematic Review and Meta-Analysis.” Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists (2026). PMID: 41833301 ↗

    L2aSR_OBSCited in: Differential Diagnosis, Management
  134. [134]

    Kushnir Y, Barrera N, Arias-Sanchez P et al.. “Intensified blood pressure control during hospital admission and on discharge: a systematic review and meta-analysis of retrospective cohort studies.” Frontiers in cardiovascular medicine (2026). PMID: 41725942 ↗

    L2aSR_OBSCited in: Differential Diagnosis
  135. [135]

    Benabbas R, Zehtabchi S, Wakai A et al.. “Cardiac Biomarkers, Echocardiography, and Outpatient Cardiac Monitoring for Evaluation of Emergency Department Patients With Syncope: A Systematic Review and Analysis of Direct Evidence for SAEM GRACE.” Academic emergency medicine : official journal of the Society for Academic Emergency Medicine (2026). PMID: 41201260 ↗

    L2aSR_OBSCited in: Differential Diagnosis
  136. [136]

    Qazi SU, Zaide DB, Fatima U et al.. “Long term outcomes of thoracic endovascular repair versus optimal medical therapy for uncomplicated Stanford type B aortic dissection: a systematic review and meta-analysis.” Future cardiology (2025). PMID: 40923587 ↗

    L2aSR_OBSCited in: Differential Diagnosis
  137. [137]

    Nouri A, Awashra A, Hamdan D et al.. “Cardiovascular toxicity of Fruquintinib in patients with colorectal and other cancers: a systematic review and meta-analysis.” Cardio-oncology (London, England) (2025). PMID: 40993794 ↗

    L2aSR_OBSCited in: Differential Diagnosis
  138. [138]

    Fukano K, Sasabuchi Y, Matsui H et al.. “Preoperative coronary angiography and outcomes in acute type A aortic dissection with coronary malperfusion: A retrospective cohort study.” Cardiovascular revascularization medicine : including molecular interventions (2025). PMID: 41125468 ↗

    L2bCOHORTCited in: Differential Diagnosis
  139. [139]

    Li XD, Chen ZJ. “Aortic dissection disguised as musculoskeletal condition: a case report and review of literature.” BMC musculoskeletal disorders (2025). PMID: 41023648 ↗

    L4CASE_REPORTCited in: Differential Diagnosis
  140. [140]

    Lu G, Wang X, Wang X et al.. “Case Report: Rapid progression of inflammation-driven coronary artery lesions in a normolipidemic patient with ANCA-associated vasculitis complicated by Stanford type A aortic dissection.” Frontiers in immunology (2026). PMID: 41909680 ↗

    L4CASE_REPORTCited in: Differential Diagnosis
  141. [141]

    Qiu F, Luo L, Huang J et al.. “Case Report: Improved axillary artery cannulation and extracorporeal membrane oxygenation bridging therapy for cardiogenic shock caused by Marfan syndrome combined with aortic dissection.” Frontiers in cardiovascular medicine (2026). PMID: 41908050 ↗

    L4CASE_REPORTCited in: Differential Diagnosis
  142. [142]

    Ji B, Lai Y, Liu XB et al.. “Aortic Root Dissection Masquerading as Acute Coronary Syndrome: The Critical Role of Intravascular Ultrasound.” Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2026). PMID: 41264798 ↗

    L4CASE_REPORTCited in: Differential Diagnosis
  143. [143]

    Wang H, Bello J, Gala D et al.. “Aortic Dissection With Pseudoaneurysm Formation Masquerading as Pulmonary Embolism After Transcatheter Aortic Valve Replacement.” Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2025). PMID: 40908904 ↗

    L4CASE_REPORTCited in: Differential Diagnosis
  144. [144]

    Leinweber ME, Hofmann AG. “Seasonality of Selected Cardiovascular Disorders in Austria: A Retrospective Observational Study Between 2009 and 2023.” Journal of the American Heart Association (2026). PMID: 41988963 ↗

    L5OTHERCited in: Differential Diagnosis
  145. [145]

    Patel S, Desai ND, Brinster DR et al.. “Type A acute aortic dissection complicated by preoperative myocardial infarction: Insights from the International Registry of Acute Aortic Dissection.” JTCVS open (2026). PMID: 41960051 ↗

    L5OTHERCited in: Differential Diagnosis, Landmark Trials and Key Evidence
  146. [146]

    Luo Y, Peng J, Peng W et al.. “Development and evaluation of an artificial intelligence-based electrocardiogram prediction model for emergency chest pain patients.” Frontiers in medicine (2026). PMID: 41884147 ↗

    L5OTHERCited in: Differential Diagnosis
  147. [147]

    Zhou F, Zhou X, Yang L et al.. “Evaluation of CT-FFR for Predicting Myocardial Ischaemia in Patients With Type A Aortic Dissection.” European heart journal. Cardiovascular Imaging (2026). PMID: 41748322 ↗

    L5OTHERCited in: Differential Diagnosis
  148. [148]

    Kwinta A, Bielański P, Szkudlarek O et al.. “Feasibility and outcomes of anaesthesiology- and intensive care-led ECPR in a hospital without cardiac surgery: a 2.5-year prospective registry.” BMC anesthesiology (2026). PMID: 41699484 ↗

    L5OTHERCited in: Differential Diagnosis
  149. [149]

    Wan Z, Jama K, Hasemaki N et al.. “Outcomes after Endovascular Arch Repair in Patients with a Native Ascending Aorta Diameter Greater than 38 mm: An Observational Study in Two High Volume Centres.” European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery (2026). PMID: 41554372 ↗

    L5OTHERCited in: Differential Diagnosis
  150. [150]

    Fujiyoshi T, Kumamaru H, Ogino H et al.. “Surgical treatment for acute aortic dissection with coronary malperfusion in Japan: Nationwide database analysis.” JTCVS open (2025). PMID: 41473077 ↗

    L5OTHERCited in: Differential Diagnosis
  151. [151]

    Zhou Y, Chen C, Li J et al.. “Identification and Validation of Differentially Expressed mRNAs From Peripheral Leukocytes for Acute Stanford Type A Aortic Dissection.” Journal of the American Heart Association (2025). PMID: 41378480 ↗

    L5OTHERCited in: Differential Diagnosis
  152. [152]

    Hoppe JM, Schramm MC, Diegruber K et al.. “Identification of diagnostic markers for MINOCA in ST-segment elevation myocardial infarction patients.” Frontiers in cardiovascular medicine (2025). PMID: 41341294 ↗

    L5OTHERCited in: Differential Diagnosis
  153. [153]

    Szeto WY, Fukuhara S, Fleischman F et al.. “One-Year Results of Novel Aortic Arch Hybrid Prosthesis for Repair of Acute DeBakey Type I Dissection With Malperfusion: PERSEVERE Study.” The Annals of thoracic surgery (2025). PMID: 41238072 ↗

    L5OTHERCited in: Differential Diagnosis
  154. [154]

    Tang J, Chen F, Wu D. “Early auxiliary diagnosis model for chest pain triad based on artificial intelligence multimodal fusion.” JAMIA open (2025). PMID: 41041626 ↗

    L5OTHERCited in: Differential Diagnosis
  155. [155]

    Haimovich JS, Kolossváry M, Alam R et al.. “Risk stratification of chest pain in the emergency department using artificial intelligence applied to electrocardiograms.” Open heart (2025). PMID: 40889954 ↗

    L5OTHERCited in: Differential Diagnosis
  156. [156]

    Guo W, Sun G, Zhang H et al.. “The G-branch off-the-shelf mixed branch endograft for thoracoabdominal aortic aneurysm: 1-year results from a prospective multicenter study.” International journal of surgery (London, England) (2025). PMID: 40865966 ↗

    L5OTHERCited in: Differential Diagnosis
  157. [157]

    Irshad S, Adrejiya P, Abubaker M et al.. “Kommerell's Diverticulum Masquerading in a Right Aortic Arch: A Vascular Surprise.” Methodist DeBakey cardiovascular journal (2025). PMID: 40860769 ↗

    L4CASE_REPORTCited in: Differential Diagnosis
  158. [158]

    Papakonstantinou NA, Antonopoulos CN. “Extracorporeal Membrane Oxygenation Following Acute Type A Aortic Dissection Repair: A Systematic Review and Meta-Analysis.” ASAIO journal (American Society for Artificial Internal Organs : 1992) (2026). PMID: 41736226 ↗

    L2aSR_OBSCited in: Management, Supportive Care and Complication Management
  159. [159]

    Amvrazi AV, Antonopoulos CN, Spath P et al.. “Outcomes of Custom Made and Off the Shelf Endografts for Preservation of the Left Subclavian Artery during Thoracic Endovascular Aortic Repair: A Systematic Review and Meta-analysis.” European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery (2026). PMID: 41905582 ↗

    L2aSR_OBSCited in: Management
  160. [160]

    Donndorf P, Angles T, Schafmayer C et al.. “Urgent and Emergent Endovascular Treatment of the Downstream Aorta Soon After Open Surgical Repair in Acute Type A Aortic Dissection: Analyzing Indications and Outcomes of an Institutional Case Series.” Journal of clinical medicine (2026). PMID: 41682617 ↗

    L4CASE_REPORTCited in: Management
  161. [161]

    Gu JJ, Zhao TY, Tian XC et al.. “Mixed Reality-Assisted Thoracic Endovascular Aortic Repair: A Retrospective Study on Efficacy and Safety.” Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc (2026). PMID: 41913345 ↗

    L2bCOHORTCited in: Management, Supportive Care and Complication Management
  162. [162]

    Peng HH, Fang QB, Wang L et al.. “Modified Candy Plug for False Lumen Embolization in Chronic Aortic Dissection: Technical Aspects and Initial Experience.” Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists (2026). PMID: 41978486 ↗

    L5OTHERCited in: Management
  163. [163]

    Marzano A, Gagliardo di Carpinello G, Giordano A et al.. “Dedicated Single-Branch Platforms for Totally Endovascular Zone 2 TEVAR with LSA Revascularization: A Comparison of Castor/Cratos and Gore TAG Thoracic Branch Endoprosthesis.” Journal of clinical medicine (2026). PMID: 41976960 ↗

    L5REVIEW_NARRATIVECited in: Management
  164. [164]

    Fang J, Cao Z, Zhang Y et al.. “Outcomes of Zone 1 Thoracic Endovascular Aortic Repair with Single Branched Stent Graft and Left Common Carotid Artery Chimney Stenting for Zone 2 Aortic Arch Pathologies.” European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery (2026). PMID: 41936860 ↗

    L5OTHERCited in: Management
  165. [165]

    Li N, Ge S, Hu J et al.. “Castor stent reconstruction of left subclavian artery reduces the incidence of postoperative cerebral infarction of type B aortic dissection with insufficient proximal landing area: a propensity score matched analysis.” Frontiers in cardiovascular medicine (2026). PMID: 41908054 ↗

    L5OTHERCited in: Management
  166. [166]

    Deng L, Li H, Yu W et al.. “Mid-and Long-Term Outcomes of Thoracic Endovascular with branch artery revascularization in the Aortic Repair for Non-A Non-B Aortic Dissection.” Seminars in thoracic and cardiovascular surgery (2026). PMID: 41903628 ↗

    L5OTHERCited in: Management
  167. [167]

    Atash A, Mees BME, Cramer MJ et al.. “MYH11 variants in thoracic aortic aneurysm pathophysiology: From bench to bedside.” European journal of clinical investigation (2026). PMID: 41891259 ↗

    L5REVIEW_NARRATIVECited in: Management
  168. [168]

    Keschenau PR, Bandzius N, Weiß B et al.. “Effect of the Proximal Landing Zone Quality on TEVAR Outcomes-11-Year Real-World Experience with the Relay Stent Graft Family in Aortic Dissections.” Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists (2026). PMID: 41872993 ↗

    L5OTHERCited in: Management
  169. [169]

    D'Onofrio A, Caraffa R, Cibin G et al.. “Suitability Analysis of 2 Devices for Endovascular Aortic Arch Repair Following Type A Aortic Dissection Surgery.” European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery (2026). PMID: 41803625 ↗

    L5OTHERCited in: Management
  170. [170]

    Zhao Y, Qian J, He H et al.. “A Novel Method Improving Estimation of Distal Landing Zone and Remodeling in Endovascular Repair of Type B Aortic Dissection.” Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists (2026). PMID: 41728920 ↗

    L5OTHERCited in: Management
  171. [171]

    Tinelli G, Sica S, Tsilimparis N et al.. “Open surgery versus branched endovascular repair of the aortic arch in residual dissections after type A surgical repair.” The British journal of surgery (2026). PMID: 41701205 ↗

    L5OTHERCited in: Management, Supportive Care and Complication Management
  172. [172]

    Jiang X, Fu W, Lu W et al.. “Intimo-Intimal Intussusception during Endovascular Repair of Type B Aortic Dissection.” European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery (2026). PMID: 41679455 ↗

    L5OTHERCited in: Management
  173. [173]

    Dean A, Feng K, Hassan S et al.. “Midterm Outcomes of the Knickerbocker Technique following Thoracic Endovascular Aortic Repair for Chronic Post-dissection Thoracic Aortic Aneurysms: A Single Centre Experience.” European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery (2026). PMID: 41672344 ↗

    L5OTHERCited in: Management
  174. [174]

    Wang F, Li H, Wang Y et al.. “Endovascular treatment of retrograde type A aortic dissection: a decade of experience in a single-center.” Frontiers in cardiovascular medicine (2026). PMID: 41623614 ↗

    L5OTHERCited in: Management
  175. [175]

    Jiang X, Zou L, Liu H et al.. “Endovascular Repair for Type B Aortic Dissection Accompanied by Retrograde Intramural Haematoma.” European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery (2026). PMID: 41619797 ↗

    L5OTHERCited in: Management, Supportive Care and Complication Management
  176. [176]

    Boshkoski G, Natour D, Jankulovski A et al.. “First Reported Use of the AMDS Hybrid Prosthesis for Secondary Type A Aortic Dissection After Prior TEVAR.” Journal of cardiovascular development and disease (2026). PMID: 41892729 ↗

    L4CASE_REPORTCited in: Management
  177. [177]

    Pitts L, Kofler M, Montagner M et al.. “Total Arch Replacement with a New Hybrid Device to Manage the Left Subclavian Artery in the Frozen Elephant Trunk Technique.” Interdisciplinary cardiovascular and thoracic surgery (2026). PMID: 41808447 ↗

    L4CASE_REPORTCited in: Management
  178. [178]

    Asta L, Mancini V, Mantini C et al.. “Aortic dissection in a Jehovah's witness: Frozen Elephant Trunk and subsequent 4D flow MRI analysis, a case report.” Journal of cardiothoracic surgery (2026). PMID: 41715223 ↗

    L4CASE_REPORTCited in: Management
  179. [179]

    Zhao HY, Gan LX, Guo HW. “Fatal delayed superior mesenteric artery thrombosis after frozen elephant trunk repair in acute type a aortic dissection with false lumen perfusion: a case report.” Journal of cardiothoracic surgery (2026). PMID: 41689049 ↗

    L4CASE_REPORTCited in: Management
  180. [180]

    Santos K, Oya K, Umibe T et al.. “Does Autologous Platelet-Rich Plasma Improve Blood Conservation and Postoperative Outcomes in Acute Type A Aortic Dissection Surgery? A Systematic Review and Meta-Analysis.” Journal of cardiothoracic and vascular anesthesia (2026). PMID: 41107167 ↗

    L2aSR_OBSCited in: Supportive Care and Complication Management
  181. [181]

    Agard G, Tonon D, Collart F et al.. “Arterial Hypotension During Cardiopulmonary Bypass and Postoperative Lung Injury in Patients Undergoing Urgent Surgery for Acute Type A Aortic Dissection: A Propensity Score-matched Retrospective Cohort Study.” Journal of cardiothoracic and vascular anesthesia (2026). PMID: 41193309 ↗

    L2bCOHORTCited in: Supportive Care and Complication Management
  182. [182]

    Bohatch Júnior MS, de Melo Silva B, Soares EAG et al.. “Endovascular Repair in High-Risk Uncomplicated Type B Aortic Dissection: A Systematic Review and Single-Arm Meta-Analysis.” Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists (2026). PMID: 41578935 ↗

    L2aSR_OBSCited in: Supportive Care and Complication Management
  183. [183]

    Matsumoto R, Watanabe T, Kinoshita R et al.. “Sex-Based Differences in Dissection Patterns and Surgical Strategies in Tear-Oriented Repair for Acute Type A Aortic Dissection: A Single-Center Retrospective Study.” Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia (2026). PMID: 41565270 ↗

    L2bCOHORTCited in: Supportive Care and Complication Management
  184. [184]

    Ye M, Xue C, Wang D et al.. “Endovascular reperfusion followed by delayed open aortic repair in stable acute type A aortic dissection with malperfusion syndrome: a single-center experience.” Frontiers in medicine (2025). PMID: 41755990 ↗

    L5OTHERCited in: Supportive Care and Complication Management
  185. [185]

    Takauchi T, Hirao S, Yaegashi K et al.. “Lateral Ventricular Symmetry as a Predictor of Postoperative Neurological Outcomes in Acute Type A Aortic Dissection With Cerebral Malperfusion.” European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery (2026). PMID: 41656890 ↗

    L5OTHERCited in: Supportive Care and Complication Management
  186. [186]

    Ma WG, Chen Y, Chen SW et al.. “Frozen elephant trunk for acute type A aortic dissection: long-term outcomes over two decades.” European heart journal (2026). PMID: 41614598 ↗

    L5OTHERCited in: Supportive Care and Complication Management
  187. [187]

    Sohn B, Lee JH, Lee H et al.. “Central Aortic Cannulation as a Primary Strategy in Acute Type A Aortic Dissection Surgery.” European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery (2026). PMID: 41570093 ↗

    L5OTHERCited in: Supportive Care and Complication Management
  188. [188]

    Giuffrè G, Pennetta FF, Palmier M et al.. “Impact of false lumen occluders on aortic remodeling after endovascular repair of chronic type B dissection.” Journal of vascular surgery (2026). PMID: 41512935 ↗

    L5OTHERCited in: Supportive Care and Complication Management
  189. [189]

    Mei X, Ji S, Jiang Y et al.. “Preoperative serum Raman spectroscopy and machine learning for predicting postoperative acute kidney injury after acute type A aortic dissection.” Renal failure (2025). PMID: 41503972 ↗

    L5OTHERCited in: Supportive Care and Complication Management
  190. [190]

    Yalzadeh D, Tabibian K, Sakowitz S et al.. “Surgical repair of type A aortic dissection at safety-net hospitals across the United States.” Surgery (2026). PMID: 41500074 ↗

    L5OTHERCited in: Supportive Care and Complication Management
  191. [191]

    Yang S, Zhang X, Wu X et al.. “Three-branched in situ laser fenestration for the endovascular repair of total aortic arch disease: A retrospective analysis of 5-year outcomes.” Journal of vascular surgery (2025). PMID: 41423026 ↗

    L5OTHERCited in: Supportive Care and Complication Management
  192. [192]

    Sato H, Iba Y, Mikami T et al.. “Comparison of 3 Surgical Procedures for DeBakey Type I Acute Aortic Dissection: When Is Frozen Elephant Trunk Recommended?” European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery (2025). PMID: 41247077 ↗

    L5OTHERCited in: Supportive Care and Complication Management
  193. [193]

    Rebello KR, Green SY, Weldon SA et al.. “Early outcomes for women and men after open extent III thoracoabdominal aortic aneurysm repair.” Journal of vascular surgery (2026). PMID: 41197838 ↗

    L5OTHERCited in: Supportive Care and Complication Management
  194. [194]

    Chandra VM, Norton EL, Khaja MS et al.. “Surgical and endovascular repair for type B aortic dissections with mesenteric malperfusion syndrome: A systematic review of in-hospital mortality.” JTCVS open (2022). PMID: 36590716 ↗

    L2aSR_OBSCited in: Landmark Trials and Key Evidence
  195. [195]

    Yip A, Libhaber E, Nam P et al.. “A Systematic Review of Acute Thoracic Aortic Dissections in Africa-The Need for a Registry.” Aorta (Stamford, Conn.) (2022). PMID: 36539145 ↗

    L2aSR_OBSCited in: Landmark Trials and Key Evidence
  196. [196]

    Harris KM, Parikh NB, Nienaber CA et al.. “Iatrogenic aortic dissection: Insights from the International Registry of Acute Aortic Dissection.” The Journal of thoracic and cardiovascular surgery (2025). PMID: 40414525 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  197. [197]

    Gilon D, Korach A, Carbone A et al.. “Cardiac Tamponade Complicating Type A Acute Aortic Dissection: Insights From 25 Years of Registry Research.” JACC. Advances (2025). PMID: 39999651 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  198. [198]

    Bossone E, Eagle KA, Nienaber CA et al.. “Acute Aortic Dissection: Observational Lessons Learned From 11 000 Patients.” Circulation. Cardiovascular quality and outcomes (2024). PMID: 39145396 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  199. [199]

    Ogami T, Arnaoutakis GJ, Isselbacher EM et al.. “Long-term outcomes after recurrent acute thoracic aortic dissection: Insights from the International Registry of Aortic Dissection.” The Journal of thoracic and cardiovascular surgery (2025). PMID: 38678471 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  200. [200]

    Pollari F, Nardi P, Mikus E et al.. “Comparison of 4 mortality scores for surgical repair of type A aortic dissection: a multicentre external validation.” European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery (2024). PMID: 38212996 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  201. [201]

    Filiberto AC, Ramadan OI, Wang GJ et al.. “Sex disparities in patients with acute aortic dissection: A scoping review.” Seminars in vascular surgery (2023). PMID: 38030323 ↗

    L5REVIEW_NARRATIVECited in: Landmark Trials and Key Evidence
  202. [202]

    Trimarchi S, Mandigers TJ, Bissacco D et al.. “Twenty-five years of observations from the International Registry of Acute Aortic Dissection (IRAD) and its impact on the cardiovascular scientific community.” The Journal of thoracic and cardiovascular surgery (2024). PMID: 37453718 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  203. [203]

    Ogami T, Arnaoutakis GJ, Patel HJ et al.. “Postoperative acute kidney injury after thoracic endovascular aortic repair for acute type B aortic dissection.” Journal of vascular surgery (2023). PMID: 37327951 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  204. [204]

    Mehta CK, Chiu S, Hoel AW et al.. “Implementation of a direct-to-operating room aortic emergency transfer program: Expedited management of type A aortic dissection.” The American journal of emergency medicine (2023). PMID: 37270850 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  205. [205]

    Trimarchi S, Gleason TG, Brinster DR et al.. “Editor's Choice - Trends in Management and Outcomes of Type B Aortic Dissection: A Report From the International Registry of Aortic Dissection.” European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery (2023). PMID: 37201718 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  206. [206]

    Arnaoutakis GJ, Ogami T, Patel HJ et al.. “Acute Kidney Injury in Patients Undergoing Surgery for Type A Acute Aortic Dissection.” The Annals of thoracic surgery (2023). PMID: 36370884 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  207. [207]

    Wolfe SB, Sundt TM, Isselbacher EM et al.. “Survival after operative repair of acute type A aortic dissection varies according to the presence and type of preoperative malperfusion.” The Journal of thoracic and cardiovascular surgery (2024). PMID: 36333247 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  208. [208]

    Catalano MA, Mamdouhi T, Pupovac S et al.. “Age, sex, and contemporary outcomes in surgical repair of type A aortic dissection: Insights from the National Inpatient Sample.” JTCVS open (2022). PMID: 36172443 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  209. [209]

    Harris KM, Nienaber CA, Peterson MD et al.. “Early Mortality in Type A Acute Aortic Dissection: Insights From the International Registry of Acute Aortic Dissection.” JAMA cardiology (2022). PMID: 36001309 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  210. [210]

    Slaven J, Evans M, Partyka C et al.. “Characteristics, clinical findings and outcomes of acute aortic dissection: A comparison between an Australian emergency department and the International Registry of Acute Aortic Dissection.” Emergency medicine Australasia : EMA (2022). PMID: 35636964 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  211. [211]

    Ganapathi AM, Ranney DN, Peterson MD et al.. “Location of Aortic Enlargement and Risk of Type A Dissection at Smaller Diameters.” Journal of the American College of Cardiology (2022). PMID: 35550685 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  212. [212]

    Reutersberg B, Gleason T, Desai N et al.. “Neurological event rates and associated risk factors in acute type B aortic dissections treated by thoracic aortic endovascular repair.” The Journal of thoracic and cardiovascular surgery (2024). PMID: 35260280 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  213. [213]

    Hemli JM, Pupovac SS, Gleason TG et al.. “Management of acute type A aortic dissection in the elderly: an analysis from IRAD.” European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery (2022). PMID: 34977934 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  214. [214]

    Reutersberg B, Trimarchi S, Gilon D et al.. “Pleural effusion: a potential surrogate marker for higher-risk patients with acute type B aortic dissections.” European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery (2022). PMID: 34966915 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  215. [215]

    Kalogerakos PD, Zafar MA, Li Y et al.. “Root Dilatation Is More Malignant Than Ascending Aortic Dilation.” Journal of the American Heart Association (2021). PMID: 34238012 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  216. [216]

    Angleitner P, Brinster DR, Gleason TG et al.. “Type A Acute Aortic Dissection Presenting With Cerebrovascular Accident at Advanced Age.” Seminars in thoracic and cardiovascular surgery (2022). PMID: 34146671 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  217. [217]

    Huckaby LV, Sultan I, Trimarchi S et al.. “Sex-Based Aortic Dissection Outcomes From the International Registry of Acute Aortic Dissection.” The Annals of thoracic surgery (2022). PMID: 34090668 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  218. [218]

    Loor G, Gleason TG, Myrmel T et al.. “Effect of Aortic Valve Type on Patients Who Undergo Type A Aortic Dissection Repair.” Seminars in thoracic and cardiovascular surgery (2022). PMID: 33984483 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  219. [219]

    Harky A, Mason S, Othman A et al.. “Outcomes of acute type A aortic dissection repair: Daytime versus nighttime.” JTCVS open (2021). PMID: 36003743 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  220. [220]

    Lin TW, Tsai MT, Wu HY et al.. “Outcomes of acute type A aortic dissection operations performed by early-career cardiovascular surgeons.” JTCVS open (2021). PMID: 36003577 ↗

    L5OTHERCited in: Landmark Trials and Key Evidence
  221. [221]

    Eghan P, Folson AA, Donkor A et al.. “Relationship between hypertensive disorders of pregnancy (HDP) and cardiac remodeling during pregnancy: Systematic review and meta-analysis.” European journal of obstetrics, gynecology, and reproductive biology (2024). PMID: 38749071 ↗

    L2aSR_OBSCited in: Special Populations
  222. [222]

    John S, Young LT, Lacro RV et al.. “Extracardiac Manifestations Fail to Predict the Severity of Cardiac Phenotype in Children and Young Adults with Marfan Syndrome.” Pediatric cardiology (2025). PMID: 38727826 ↗

    L1bRCTCited in: Special Populations
  223. [223]

    Thunström S, Thunström E, Naessén S et al.. “All-cause mortality and death by aortic dissection in women with Turner syndrome: A national clinical cohort study.” American heart journal (2025). PMID: 39603484 ↗

    L2bCOHORTCited in: Special Populations
  224. [224]

    Liu H, Yang L, Chen CY et al.. “Management strategies and outcomes in pregnancy-related acute aortic dissection: a multicentre cohort study in China.” Heart (British Cardiac Society) (2024). PMID: 39266045 ↗

    L2bCOHORTCited in: Special Populations
  225. [225]

    Thunström S, Wide U, Landin-Wilhelmsen K et al.. “Psychiatric disorders and comorbidity in women with Turner Syndrome: a retrospective national cohort study.” Translational psychiatry (2024). PMID: 39227579 ↗

    L2bCOHORTCited in: Special Populations
  226. [226]

    Samman B, Deng MX, Chung JCY et al.. “Understanding Thoracic Aortic Disease in Women.” Circulation research (2025). PMID: 40080538 ↗

    L5REVIEW_NARRATIVECited in: Special Populations
  227. [227]

    . “Maternal cardiovascular morbidity and mortality associated with pregnancy in individuals with Turner syndrome: a committee opinion.” Fertility and sterility (2024). PMID: 38980250 ↗

    L5REVIEW_NARRATIVECited in: Special Populations
  228. [228]

    Nariai M, Wada-Hiraike O, Sasabuchi Y et al.. “Aortic dissection during the perinatal period in women with Marfan-related disorders: a retrospective cohort study using the Japanese Diagnosis Procedure Combination database.” The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (2026). PMID: 41866242 ↗

    L2bCOHORTCited in: Special Populations
  229. [229]

    Chan CH, Chow SC, Chang AT et al.. “Emergency Bentall Procedure for Acute Type A Aortic Dissection in a Patient With Preterm Twin Pregnancy.” The Annals of thoracic surgery (2025). PMID: 40466851 ↗

    L4CASE_REPORTCited in: Special Populations
  230. [230]

    Wang Z, Yu X, Ding S et al.. “Management and outcomes of aortic dissection type B in late pregnancy: A retrospective case series.” BJOG : an international journal of obstetrics and gynaecology (2024). PMID: 39075929 ↗

    L4CASE_REPORTCited in: Special Populations
  231. [231]

    Trajkovski AV, Reiner K, Džaja N et al.. “Anesthetic management for cesarean section in two parturient with ascending aortic aneurysm: a case-based discussion.” BMC anesthesiology (2024). PMID: 38711027 ↗

    L4CASE_REPORTCited in: Special Populations
  232. [232]

    Manolis AA, Manolis TA, Vouliotis A et al.. “Ascending Aorta Aneurysm: What the Cardiologist Needs to Know.” Angiology (2026). PMID: 41919573 ↗

    L5REVIEW_NARRATIVECited in: Special Populations
  233. [233]

    de Groote K, Patel SR, Mortensen KH et al.. “Management of Cardiovascular Health Issues in Turner Syndrome: Expert Insights and Expanded Recommendations From the 2024 Guideline Development Team.” American journal of medical genetics. Part C, Seminars in medical genetics (2025). PMID: 40135715 ↗

    L5REVIEW_NARRATIVECited in: Special Populations
  234. [234]

    Tournoy TK, D'hulst S, Demolder A et al.. “Telomere length in patients with Marfan Syndrome.” International journal of cardiology (2026). PMID: 41679654 ↗

    L5OTHERCited in: Special Populations
  235. [235]

    De Gaspari M, Basso C, Dalla Zanna F et al.. “A 4-Decade Population-Based Registry of Thoracic Aortic Dissection Causing Sudden Death in the Young.” JACC. Advances (2026). PMID: 41475307 ↗

    L5OTHERCited in: Special Populations
  236. [236]

    Shrestha M, Kaufeld T, Rudolph L et al.. “Should We Replace the Non-Aneurysmal Aortic Arch During Elective Valve-Sparing Aortic Root Replacement in Marfan Patients?” European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery (2026). PMID: 41442164 ↗

    L5OTHERCited in: Special Populations
  237. [237]

    Van Der Zande JA, Grewal J, Franx A et al.. “Cardiovascular outcomes and aortic growth in pregnant women with Turner syndrome: data from the ESC EORP Registry Of Pregnancy And Cardiac disease (ROPAC) III.” European journal of preventive cardiology (2025). PMID: 40916742 ↗

    L5OTHERCited in: Special Populations
  238. [238]

    Figueroa AV, Tanenbaum MT, Costa Filho JE et al.. “Landing zones optimization using transcatheter electrosurgical septotomy for endovascular repair of post-dissection aortic aneurysms.” Journal of vascular surgery (2025). PMID: 40780667 ↗

    L5OTHERCited in: Special Populations
  239. [239]

    Peters PNJ, van der Zande JA, De Backer J et al.. “Pregnancy outcomes in women with heritable thoracic aortic disease: data from the EORP ESC registry of pregnancy and cardiac disease (ROPAC) III.” European heart journal. Quality of care & clinical outcomes (2025). PMID: 40576452 ↗

    L5OTHERCited in: Special Populations
  240. [240]

    Bouhatous YM, Arnaud P, Jondeau G et al.. “Shprintzen-Goldberg syndrome: follow-up of the cardiovascular features in an international cohort of 29 patients with SGS.” Journal of medical genetics (2025). PMID: 40562530 ↗

    L5OTHERCited in: Special Populations
  241. [241]

    Narula N, Schwartz Y, Devereux RB et al.. “Clinical and Phenotypic Correlates of Mitral Valve Prolapse in Marfan Syndrome: The Cornell Aortic Aneurysm Registry.” Journal of the American Heart Association (2025). PMID: 40357669 ↗

    L5OTHERCited in: Special Populations
  242. [242]

    Soto ME, Rodríguez-Brito M, Pérez-Torres I et al.. “Analysis of FBN1, TGFβ2, TGFβR1 and TGFβR2 mRNA as Key Molecular Mechanisms in the Damage of Aortic Aneurysm and Dissection in Marfan Syndrome.” International journal of molecular sciences (2025). PMID: 40243722 ↗

    L5OTHERCited in: Special Populations
  243. [243]

    Campello Jorge CA, Marway PS, Tjahjadi NS et al.. “Growth Rate Assessed by Vascular Deformation Mapping Predicts Type B Aortic Dissection in Marfan Syndrome.” Journal of the American Heart Association (2025). PMID: 40008501 ↗

    L5OTHERCited in: Special Populations
  244. [244]

    Zhou X, Xu Q, Hu X et al.. “PP2A Attenuates Thoracic Aneurysm and Dissection in Mouse Models of Marfan Syndrome.” Hypertension (Dallas, Tex. : 1979) (2025). PMID: 39878024 ↗

    L5OTHERCited in: Special Populations
  245. [245]

    Chen SW, Chang FC, Chen CY et al.. “Pregnancy, aortic events, and neonatal and maternal outcomes.” European heart journal (2025). PMID: 39528388 ↗

    L5OTHERCited in: Special Populations
  246. [246]

    Butnariu LI, Russu G, Luca AC et al.. “Identification of Genetic Variants Associated with Hereditary Thoracic Aortic Diseases (HTADs) Using Next Generation Sequencing (NGS) Technology and Genotype-Phenotype Correlations.” International journal of molecular sciences (2024). PMID: 39456956 ↗

    L5OTHERCited in: Special Populations
  247. [247]

    Thomas R, Dhanekula AS, Byers P et al.. “Elective root replacement increases the risk of type B dissection in patients with Marfan syndrome.” The Journal of thoracic and cardiovascular surgery (2025). PMID: 39326730 ↗

    L5OTHERCited in: Special Populations
  248. [248]

    Claus J, Schoof L, Mir TS et al.. “Late diagnosis of Marfan syndrome is associated with unplanned aortic surgery and cardiovascular death.” The Journal of thoracic and cardiovascular surgery (2025). PMID: 39306029 ↗

    L5OTHERCited in: Special Populations
  249. [249]

    Valdivia Callejon I, Buccioli L, Bastianen J et al.. “Investigation of Strategies to Block Downstream Effectors of AT1R-Mediated Signalling to Prevent Aneurysm Formation in Marfan Syndrome.” International journal of molecular sciences (2024). PMID: 38732244 ↗

    L5OTHERCited in: Special Populations
  250. [250]

    Cha HJ, Kim JW, Moon SH et al.. “Lobar torsion following open surgical repair for type B aortic dissection in a patient with Marfan syndrome.” Journal of cardiothoracic surgery (2025). PMID: 41353160 ↗

    L4CASE_REPORTCited in: Special Populations
  251. [251]

    Isselbacher EM, Preventza O, Hamilton Black J et al.. “2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines.” Circulation (2022). PMID: 36322642 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  252. [252]

    Isselbacher EM, Preventza O, Hamilton Black Iii J et al.. “2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines.” Journal of the American College of Cardiology (2022). PMID: 36334952 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  253. [253]

    Isselbacher EM, Preventza O, Hamilton Black J et al.. “2022 ACC/AHA guideline for the diagnosis and management of aortic disease: A report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines.” The Journal of thoracic and cardiovascular surgery (2023). PMID: 37389507 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  254. [254]

    Lombardi JV, Hughes GC, Appoo JJ et al.. “Society for Vascular Surgery (SVS) and Society of Thoracic Surgeons (STS) reporting standards for type B aortic dissections.” Journal of vascular surgery (2020). PMID: 32001058 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  255. [255]

    Kicska GA, Hurwitz Koweek LM, Ghoshhajra BB et al.. “ACR Appropriateness Criteria® Suspected Acute Aortic Syndrome.” Journal of the American College of Radiology : JACR (2021). PMID: 34794601 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  256. [256]

    Wanhainen A, Gombert A, Antoniou GA et al.. “European Society for Vascular Surgery (ESVS) 2026 Clinical Practice Guidelines on the Management of Descending Thoracic and Thoraco-Abdominal Aortic Diseases - Editor's Choice.” European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery (2026). PMID: 41448425 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  257. [257]

    Bradley TJ, Alvarez NA, Horne SG. “A Practical Guide to Clinical Management of Thoracic Aortic Disease.” The Canadian journal of cardiology (2016). PMID: 26724515 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  258. [258]

    Hiratzka LF, Creager MA, Isselbacher EM et al.. “Surgery for aortic dilatation in patients with bicuspid aortic valves: A statement of clarification from the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.” The Journal of thoracic and cardiovascular surgery (2016). PMID: 26995623 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  259. [259]

    Hiratzka LF, Creager MA, Isselbacher EM et al.. “Surgery for Aortic Dilatation in Patients With Bicuspid Aortic Valves: A Statement of Clarification From the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.” Journal of the American College of Cardiology (2016). PMID: 26658475 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  260. [260]

    Sheeran DP, Tong RT, Khaja MS et al.. “ACR Appropriateness Criteria® Abdominal Aortic Aneurysm or Dissection-Interventional Planning and Follow-Up: Update 2025.” Journal of the American College of Radiology : JACR (2026). PMID: 41837923 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  261. [261]

    Hiratzka LF, Creager MA, Isselbacher EM et al.. “Surgery for Aortic Dilatation in Patients With Bicuspid Aortic Valves: A Statement of Clarification From the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.” Circulation (2016). PMID: 26637530 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  262. [262]

    Johansen KL, Garimella PS, Hicks CW et al.. “Central and peripheral arterial diseases in chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference.” Kidney international (2021). PMID: 33961868 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  263. [263]

    . “Increased maternal cardiovascular mortality associated with pregnancy in women with Turner syndrome.” Fertility and sterility (2006). PMID: 17055808 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  264. [264]

    Verma R, Cohen G, Colbert J et al.. “Bicuspid aortic valve associated aortopathy: 2022 guideline update.” Current opinion in cardiology (2023). PMID: 36718616 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  265. [265]

    Seki Y, Okamoto K, Ikezoe T et al.. “Clinical practice guidelines for management of disseminated intravascular coagulation in Japan 2024. Part 3: solid cancers and vascular abnormalities.” International journal of hematology (2025). PMID: 39792236 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  266. [266]

    Eggebrecht H. “[Diagnosis and treatment of aortic diseases : new guidelines of the European Society of Cardiology 2014].” Herz (2014). PMID: 25406331 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  267. [267]

    Bruyère M, Morau E, Beaumont É et al.. “[Maternal mortality due to cardiovascular disease in France 2013-2015].” Gynecologie, obstetrique, fertilite & senologie (2021). PMID: 33161192 ↗

    L1cGUIDELINECited in: Guidelines and Resources
  268. [268]

    Gao H, Liu X, Wang Y et al.. “Aortic root dilation in bicuspid aortic valve disease: impact on dissection risk and evaluation of guideline-based surgical thresholds - a retrospective cohort study.” International journal of surgery (London, England) (2025). PMID: 40479495 ↗

    L2bCOHORTCited in: Guidelines and Resources
  269. [269]

    Pak KJ, Hu T, Fee C et al.. “Acute hypertension: a systematic review and appraisal of guidelines.” Ochsner journal (2014). PMID: 25598731 ↗

    L2aSR_OBSCited in: Guidelines and Resources
  270. [270]

    Duijnhouwer A, van den Hoven A, Merkx R et al.. “Differences in Aortopathy in Patients with a Bicuspid Aortic Valve with or without Aortic Coarctation.” Journal of clinical medicine (2020). PMID: 31972995 ↗

    L5OTHERCited in: Guidelines and Resources
  271. [271]

    Seferović PM, Ristić AD, Maksimović R et al.. “Pericardial syndromes: an update after the ESC guidelines 2004.” Heart failure reviews (2013). PMID: 22855353 ↗

    L5REVIEW_NARRATIVECited in: Guidelines and Resources
  272. [272]

    Sprynger M, Rigo F, Moonen M et al.. “Focus on echovascular imaging assessment of arterial disease: complement to the ESC guidelines (PARTIM 1) in collaboration with the Working Group on Aorta and Peripheral Vascular Diseases.” European heart journal. Cardiovascular Imaging (2018). PMID: 30239635 ↗

    L5OTHERCited in: Guidelines and Resources
  273. [273]

    Mariucci EM, Lovato L, Rosati M et al.. “Dilation of peripheral vessels in Marfan syndrome: importance of thoracoabdominal MR angiography.” International journal of cardiology (2013). PMID: 22954416 ↗

    L5OTHERCited in: Guidelines and Resources

Revision History

All updates applied to this page

Loading revisions…