Intimointimal Intussusception in Acute Aortic Dissection.

Abstract

HomeRadiology: Cardiothoracic ImagingVol. 2, No. 4 PreviousNext Images in Cardiothoracic ImagingFree AccessVascular ImagingIntimointimal Intussusception in Acute Aortic DissectionLucas de Pádua Gomes de Farias , João Manoel Miranda Magalhães Santos, Gustavo Borges da Silva Teles, Luciana de Pádua Silva BaptistaLucas de Pádua Gomes de Farias , João Manoel Miranda Magalhães Santos, Gustavo Borges da Silva Teles, Luciana de Pádua Silva BaptistaAuthor AffiliationsFrom the Hospital Samaritano Paulista, Avenida Brigadeiro Luís Antônio, 1895-Bela Vista, São Paulo, SP, CEP 01317-002, Brazil.Address correspondence to L.d.P.G.d.F. (e-mail: [email protected]).Lucas de Pádua Gomes de Farias João Manoel Miranda Magalhães SantosGustavo Borges da Silva TelesLuciana de Pádua Silva BaptistaPublished Online:Aug 27 2020https://doi.org/10.1148/ryct.2020200023MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In Intimointimal intussusception in aortic dissection is a rare but potentially life-threatening type of complication (1). The intimal tear and delamination process occur circumferentially, and the intimal flap separates from the aorta, partially or totally, with the detached tissue forced downstream. Furthermore, the intussuscepted flap can obstruct the aortic arch and its branches (1–3). Lack of typical imaging findings of type A aortic dissection can be a challenge due to the absence of intimal flap in the ascending aorta (1,3) (Figure).CT angiographic images (A–C, axial multiplanar reformations [MPRs]; D, sagittal oblique; E, MPR extended; F, axial oblique; G, coronal; and H, oblique maximum intensity projection) show Stanford type A aortic dissection with an intimal flap in aortic root (arrowheads) and an intussuscepted intima (white arrow) in aortic arch, with the false lumen wrapped around the true lumen. Furthermore, no intimal flap was seen in ascending aorta (*). Right coronary artery (RCA) originates from true lumen and left main (LM) coronary artery from false lumen. Dissection also extends into the origin of the brachiocephalic trunk (black arrow) and left common carotid artery (image not included). LV = left ventricle.Download as PowerPointOpen in Image Viewer Disclosures of Conflicts of Interest: L.d.P.G.d.F. disclosed no relevant relationships. J.M.M.M.S. disclosed no relevant relationships. G.B.d.S.T. disclosed no relevant relationships. L.d.P.S.B. disclosed no relevant relationships.Keywords: Adults, Aorta, CT-Angiography, Cardiac, Carotid Arteries, Dissection, Thorax, Vascular Authors declared no funding for this work.