4th June 2026

Complications

It is essential that all patients are followed up long term to monitor for complications, including formation of aneurysms, aortic rupture, branch occlusions, malperfusion, re-dissection and other cardiovascular events. 

If there is an aortic rupture – depending on the site of the aorta that the rupture occurs in, there can be various pathophysiological consequences. 

• Ascending aorta > Rupture into the right haemothorax (sudden death) or haemopericardium (syncope and/or sudden death) 
• Arch of the aorta > Rupture into the mediastinum (mediastinal haematoma), interatrial septal haematoma, compression of pulmonary artery/trunk 
• Descending aorta > Rupture into the left haemothorax (sudden death), rupture into the oesophagus (rare), leading to haematemesis 
• Abdominal aorta > Rupture into the retroperitoneal area (back pain with shock), rupture into intraperitoneal area (shock and acute abdomen symptoms)

If there is a branch occlusion or branch vessel involvement, there may be further complications:

• Coronary vessels > Myocardial infarction (ST elevation) 
• Common carotids > Stroke (ischaemic or haemorrhagic)
• Subclavian vessels > Ischaemic upper limb 
• Coeliac/mesenteric vessels > Ischaemic bowel 
• Renal vessels > Frank haematuria 
• Spinal arteries > Painless paraplegia of sudden onset