Recognising it
The classic warning is sudden, severe, tearing chest or back pain, sometimes moving as the tear extends. Anyone with this pain should call 112 or 999 immediately.
How it is treated
- Immediate, tight blood pressure control in a high-dependency setting
- Thoracic stent grafting (TEVAR) to seal the entry tear and restore flow to organs and limbs
- Fenestration or branch stenting where the bowel, kidneys or legs are losing their blood supply
- Open surgery when the ascending aorta or arch is involved
- Lifelong blood pressure control and interval imaging
Complex and late dissection
Prof Sultan has developed and published techniques for dissection affecting the whole length of the aorta, including the kinetic elephant trunk and the TIGER protocol for disease below the diaphragm, and accepts referrals for patients others consider untreatable.
