Management of a Spontaneous Supra-aortic Arterial Dissection

A Case Report

Omar M. Sharaf; Tomas D. Martin; Eric I. Jeng

Disclosures

J Med Case Reports. 2021;15(283) 

In This Article

Background

Aortic dissections are caused by multiple etiologies including connective tissue disorders, illicit drug use, trauma, and/or uncontrolled hypertension. Acute DeBakey type I and II aortic dissections are classically managed with excision of the intimal tear with reconstruction of the aorta and postoperative long-term blood pressure control with anti-impulse therapy. Uncomplicated DeBakey type III aortic dissections have historically been managed non-operatively with strict blood pressure control regimens. On this spectrum are isolated uncomplicated supra-aortic dissections. They can be classified in two major groups: traumatic—due to an inciting event such as blunt chest trauma, deceleration events, and sports injuries; and/or spontaneous—when no inciting cause is identified.[1,2] Supra-aortic dissections can involve either single or multiple arch vessels, and the mean age for its occurrence is 45 years.[2] As a result of the rare nature of this condition, there are no uniformly approved guidelines for managing uncomplicated spontaneous isolated innominate artery dissection.[2]

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