Association of Stanford, DeBakey Classification and False-lumen Blood Flow with Age of Onset in Acute Aortic Dissection

Abstract

Background: Younger patients with acute aortic dissection (AAD) are thought to present with distinct anatomical and hemodynamic features compared with older patients. This study 2 evaluated the association between age, dissection extent, and false-lumen flow characteristics in AAD. Methods and Results: 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 versus 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. Conclusions: 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.