Pathogenesis of aortic dissection: elastic fiber abnormalities and aortic medial weakness.

Although aortic dissection was previously a disease with an extremely poor prognosis, recent advances in diagnostic imaging and therapeutic modalities may improve its prognosis.1, 2) However, much of its etiology and pathogenesis remains unknown. In addition, new pathological variants of aortic dissection, such as intramural hematoma (IMH) and penetrating atherosclerotic ulcer, and related diseases have been identified, raising a new problem. Against this background, this paper revisits the basic pathology of aortic dissection, and discusses the structural abnormalities of the aortic media and mechanism of aortic dissection, as extrapolated from them.