Abstract
Transvenous multi-modal ultrasound can safely guide percutaneous fenestration of an intimal flap. It provides longitudinal image planes of the dissected aorta and possibly involved distal vessels. The following case shows that the intimal flap may be extremely resistant to penetration with intravascular needle devices. In a 61-year-old man with type B dissection and consecutive intestinal and left renal mal- perfusion, a Brockenbrough needle-catheter was introduced into the true aortic lumen in an unsuccessful attempt to perforate the …
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