The aorta is the main artery that carries blood from the heart to the rest of the body. An aortic dissection occurs when the inner layer of the aortic wall tears, allowing blood to enter between the layers of the wall and separate them. It is a serious medical emergency that can be life-threatening if not treated promptly.

Treatment of Aortic Dissection

The type of treatment depends on the location of the dissection and the patient’s clinical stability:

• Medications: In all cases, the first step is to control blood pressure and heart rate with intravenous drugs in order to reduce the force with which blood impacts the aortic wall.
• Open surgery: In dissections involving the ascending aorta (close to the heart), urgent surgical intervention is usually required. The damaged segment is replaced with a synthetic graft.
• Endovascular treatment: In dissections of the descending aorta, an endoprosthesis (stent graft) can be placed through a catheter inserted via the groin. This seals the tear in the inner layer of the wall from within, redirecting blood flow into the true lumen and preventing progression of the dissection (Fig. 1).

Tratamiento diseccion aortica

Fig. 1: A) Dissection of the descending aorta with the entry tear located near the left subclavian artery (white arrow).
B) Endovascular and percutaneous repair with implantation of an endoprosthesis, with a prior bypass between the left carotid and left subclavian arteries (empty white arrow) to allow effective coverage of the entry tear.

Thanks to these techniques, survival rates for dissections treated in a timely manner have improved significantly in recent years.

Prevention of Aortic Dissection

Although it is not always possible to prevent aortic dissection, several measures can reduce the risk:

• Strict control of blood pressure, especially in patients with hypertension.
• Avoidance of tobacco use and maintenance of healthy lifestyle habits (balanced diet, moderate exercise, appropriate body weight).
• Regular medical follow-up in patients with risk factors, such as a family history, connective tissue diseases (e.g., Marfan syndrome), or known aneurysms.
• Adherence to medical treatment prescribed by a specialist and prompt presentation to emergency services in the event of sudden and severe chest or abdominal pain.

Conclusion

Aortic dissection is one of the most serious cardiovascular emergencies; however, with rapid diagnosis and advances in surgical and endovascular techniques, it is now possible to save many lives. Prevention relies on blood pressure control, early detection of aneurysms, and a heart-healthy lifestyle.