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than among white patients.1184,1185 Of note, the incidence of iatrogenic AD during cardiac catheterization is very low (around 0.01%–0.02%) and during cardiac surgery is 0.06%–0.23%, with favourable in-hospital and long-term prognosis.1186,1187 9.3.1.1.1 Sex differences. A specific female sex phenotype appears to

be evident in acute TAAD. At admission, acute TAAD female patients are usually older but have lower body mass index (BMI), BSA, and creatinine plasma levels. They present less frequently with active smoking,

Proximal

extent

Distal extent Type

AD Entry tear:

Zone 0 0 1 2 3 4 5 6 7 8 9 10 11 12 0 1 2 3 4 5 6 7 8 9 10 11 12

BPD Entry tear: ≥Zone 1

ID Unidentified entry

tear involving

Zone 0

Type

Entry 0 1 2 3 4

5 6 7 8

9 10

11 11

10

A B Non-A non-B

M0 - no malperfusion M1 - coronary M2 - supra-aortic M3 - spinal, visceral, iliac (-) no clinical symptoms (+) clinical symptoms

E0 E1

E E E

E2 E3 E

E0 E3 E E

E0 E3 E2

Malperfusion

T

E

M TEM aortic dissection classification

Figure 29 Aortic dissection classification system based on the 2020 Society for Vascular Surgery/Society of Thoracic Surgeons Reporting Standards and the European update of the Stanford classification—Type Entry Malperfusion classification. A, type A aortic dissection; B, type B aortic dissection; non-A, non-B, aortic dissection limited to the aortic arch or retrograde dissection extending into the arch (but not in the ascending aorta). Upper panel: Classification of AAD considering the intimal tear’s entry site and dissection extension. Subscript P describes the proximal involved aorta, and subscript D indicates the distal zone. Lower panel: The TEM classification is the European update of the Stanford classification combining information about the Type of dissection (T), the Entry site (E), and the presence of Malperfusion (M). Also refer to Supplementary data online, Section 1.6. Society for Vascular Surgery/Society of Thoracic Surgeons (SVS/STS). Reproduced with permission from.136,1180 Downloaded from academic.oup.com/eurheartj/article/45/36/3538/7738955 by guest on 07 October 2026