Results of clinical studies and surgical treatment of patients with dissecting aneurysms of the descending thoracic and abdominal aorta are discussed. A new modification of the clinicoanatomical classification of this aortic disease is proposed with the emphasis on the possibility of (1) retrograde extension of the pathological process into the aortic arch with primary intimal rupture in the descending thoracic segment, and (2) multifocal aortic lesion, a combination of dissecting aneurysm and true discrete aneurysm of the unaffected aortic portion. The possibility of performing various types of one-stage and stage-by-stage reconstruction of the descending aorta depending on the degree and extension of dissection is shown.

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