# Association of Stanford, DeBakey classification and false-lumen blood flow with age of onset in acute aortic dissection

## TL;DR

Younger patients with aortic dissection tend to have more widespread dissections and active blood flow in the false lumen, while older patients have localized dissections and blood clots in the false lumen.

## Contribution

This study identifies age-related differences in aortic dissection patterns and false-lumen blood flow, which could influence clinical management strategies.

## Key findings

- Younger patients more frequently had DeBakey type I dissections and communicating false lumen.
- Older patients more commonly had DeBakey type II dissections and non-communicating false lumen.
- Preoperative malperfusion was more common in younger patients, but 30-day mortality was similar between age groups.

## Abstract

Younger patients with acute aortic dissection (AAD) are thought to present with distinct anatomical and hemodynamic features compared with older patients. This study evaluated the association between age, dissection extent, and false-lumen flow characteristics in AAD.

We retrospectively analyzed 400 consecutive patients with radiologically confirmed AAD from April 2014 to April 2024, categorizing them into a younger group (<76 years, n = 229) and an older group (≥76 years, n = 171). The distribution of Stanford type A vs. B dissections was similar between groups. However, younger patients more frequently demonstrated DeBakey type I dissection, whereas older patients more commonly had type II. Regarding false-lumen morphology, younger patients showed a higher prevalence of communicating false lumen, while non-communicating patterns predominated in the elderly. Although overall sex distribution of false-lumen types was not significantly different, younger males were more prevalent within each subtype. Preoperative malperfusion occurred more often in younger patients, whereas 30-day mortality did not differ significantly between age groups.

Younger AAD patients typically exhibit more extensive dissection and patent false-lumen flow, while older patients more often present with localized dissection and thrombosed false lumen. These age-related distinctions may reflect progressive aortic wall stiffening and should be considered in clinical assessment and management strategies.