A 65-year-old hypertensive smoker has sudden tearing back pain. CT shows a dissection flap beginning just distal to the left subclavian artery with no involvement of the ascending aorta. This is classified as:

• A Stanford type A dissection
• B DeBakey type I dissection
• C Stanford type B dissection ✓
• D DeBakey type II dissection

Explanation

Stanford classification: Type A involves the ascending aorta (regardless of origin site); Type B does NOT involve the ascending aorta. A dissection starting distal to the left subclavian involving only the descending aorta is Stanford Type B (conservative management). DeBakey Type III also denotes descending aorta-only dissection, but the question asks for Stanford classification. Types I and II (DeBakey) or Type A (Stanford) would involve the ascending aorta.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

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Written and medically reviewed by the StethoPrep medical team.