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Patterns of visceral artery involvement and radiological malperfusion in aortic dissections

Amine Fikani1,2, Jerome Jouan3, Marouane Boukhris4

  • 1Department of Cardiothoracic Surgery, University Hospital Center, Limoges, France - aminefikani@gmail.com.

The Journal of Cardiovascular Surgery
|September 23, 2025
PubMed

Insights

Visceral artery involvement and malperfusion mechanisms differ significantly between acute type A (ATAAD) and type B (ATBAD) aortic dissections. These distinctions are crucial for guiding optimal acute aortic dissection treatment strategies.

Area of Science:

  • Vascular Surgery
  • Radiology
  • Cardiovascular Imaging

Background:

  • Acute aortic dissection (AAD) poses significant clinical challenges.
  • Understanding visceral artery involvement is critical for patient outcomes.
  • Differentiating between acute type A (ATAAD) and type B (ATBAD) aortic dissection is essential for management.

Purpose of the Study:

  • To compare visceral artery involvement in ATAAD and ATBAD.
  • To analyze and compare radiological malperfusion patterns in ATAAD and ATBAD.
  • To identify differences in branch artery involvement and malperfusion mechanisms.

Main Methods:

  • Retrospective analysis of 40 ATAAD and 40 ATBAD patients.
  • Multiplanar reconstruction for detailed luminal origin and malperfusion assessment.
  • Classification of branch perfusion patterns (true lumen, false lumen, dual lumen) and dissection involvement (Class I, II, III).

Main Results:

  • Significant differences in superior mesenteric artery and left renal artery involvement between ATAAD and ATBAD.
  • Distinct radiological malperfusion patterns observed, with more malperfusion from true lumen arteries in ATBAD.
  • No anatomical predictive factors for branch artery involvement were identified.

Conclusions:

  • Visceral branch artery involvement and malperfusion mechanisms show significant differences between ATAAD and ATBAD.
  • These findings have implications for tailoring treatment strategies in acute aortic dissection.
  • Further research may elucidate specific management pathways based on dissection type and visceral involvement.
Abstract

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