In aortic dissection, which arteries are most likely to be damaged first?

In cases of aortic dissection, the celiac trunk is the artery most likely to sustain damage first due to its anatomical position and proximity to the ascending aorta. Aortic dissections typically originate in the ascending aorta, often just above the aortic valve, and can extend downward. The celiac trunk branches off from the aorta just below the diaphragm, making it vulnerable in cases where dissection occurs in the proximal part of the aorta.

As the dissection propagates, it may involve further branches, but the initial tear generally affects arteries that are closely associated with the aorta where the dissection begins. The celiac trunk’s location places it at a higher risk compared to other arteries like the superior mesenteric artery, inferior mesenteric artery, or renal arteries, which branch off from the aorta at lower positions. Therefore, during aortic dissection, the celiac trunk is the artery that is most likely to be compromised initially, leading to potential implications for its associated organs, such as issues with blood supply to the liver, spleen, and stomach.