Sandbox:Sahar

Recomendacations	Class	Level	References
History and clinical assessment
In all patients with suspected AAS, pre-test probability assessment is recommended, according to the patient’s condition, symptoms, and clinical features.	I	B
Laboratory testing
In case of suspicion of AAS, the interpretation of biomarkers should always be considered along with the pretest clinical probability.	IIa	B
In case of low clinical probability of AAS, negative D-dimer levels should be considered as ruling out the diagnosis.	IIa	C
In case of intermediate clinical probability of AAS with a positive (point-of-care) D-dimer test, further imaging tests should be considered.	IIa	B
In patients with high probability (risk score 2 or 3) of AD, testing of D-dimers is not recommended.	III	C
Imaging
TTE is recommended as an initial imaging investigation.	I	C
In unstabled patients with a suspicion of AAS, the following imaging modalities are recommended according to local availability and expertise:
TOE	I	C
CT	I	C
In stable patients with a suspicion of AAS, the following imaging modalities are recommended (or should be considered) according to local availability and expertise:
CT	I	C
MRI	I	C
TOE	IIa	C
In case of initially negative imaging with the persistence of suspicion of AAS, repetitive imaging (CT or MRI) is recommended.	I	C
Chest X-ray maybe considered in cases of low clinical probability of AAS.	IIb	C
In case of uncomplicated Type B AD treated medically, repeated imaging (CT or MRI)e during the first days is recommended.	I	C