Images at the time of admission show increased size of the stented descending aorta with type II endoleak. Also seen is a thin rim of intramural hematoma of the ascending aorta

ASVIDE ◽  
2018 ◽  
Vol 5 ◽  
pp. 340-340
Author(s):  
Paul Schoenhagen
Keyword(s):  
Intramural Hematoma ◽  
Ascending Aorta ◽  
Type Ii ◽  
Type Ii Endoleak ◽  
Descending Aorta ◽  
Time Of Admission

scholarly journals Detection of the intimal tear in aortic dissection and ulcer-like projection in intramural hematoma: usefulness of full-phase retrospective ECG-gated CT angiography

2020 ◽  
Vol 38 (11) ◽  
pp. 1036-1045
Author(s):  
Satoru Yanagaki ◽  
Takuya Ueda ◽  
Atsuro Masuda ◽  
Hideki Ota ◽  
Yuta Onaka ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Aortic Dissection ◽  
Ct Angiography ◽  
Intramural Hematoma ◽  
Ascending Aorta ◽  
Single Center ◽  
Descending Aorta ◽  
Diastolic Phase ◽  
Electrocardiogram Ecg ◽  
Intimal Tear

Abstract Purpose To compare the accuracy of non-electrocardiogram (ECG)-gated CT angiography (CTA), single-diastolic-phase ECG-gated CTA, and full-phase ECG-gated CTA in detecting the intimal tear (IT) in aortic dissection (AD) and ulcer-like projection (ULP) in intramural hematoma (IMH). Materials and methods A total of 81 consecutive patients with AD and IMH of the thoracic aorta were included in this single-center retrospective study. Non-ECG-gated CTA, single-diastolic-phase ECG-gated CTA, and full-phase ECG-gated CTA were used to detect the presence of the IT and ULP in thoracic aortic regions including the ascending aorta, aortic arch, and proximal and distal descending aorta. Results The accuracy of detecting the IT and ULP was significantly greater using full-phase ECG-gated CTA (88% [95% CI: 100%, 75%]) than non-ECG-gated CTA (72% [95% CI: 90%, 54%], P = 0.001) and single-diastolic-phase ECG-gated CTA (76% [95% CI: 93%, 60%], P = 0.008). Conclusion Full-phase ECG-gated CTA is more accurate in detecting the IT in AD and ULP in IMH, than non-ECG-gated CTA and single-diastolic-phase ECG-gated CTA.

Thoracic Endovascular Aortic Repair for Retrograde Type A Intramural Hematoma With Intimal Disruption in the Descending Aorta

2021 ◽  
pp. 152660282110612
Author(s):  
Yingliang Wang ◽  
Songlin Song ◽  
Chen Zhou ◽  
Wenying Zhu ◽  
Jiacheng Liu ◽  
...  
Keyword(s):  
Adverse Events ◽  
Intramural Hematoma ◽  
Type A ◽  
Ascending Aorta ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Descending Aorta ◽  
Aortic Repair ◽  
Intimal Tear

Purpose: To evaluate the safety and efficacy of thoracic endovascular aortic repair (TEVAR) for retrograde type A intramural hematoma (IMH) with intimal disruption in the descending aorta and report our endovascular therapeutic experience. Materials and Methods: From January 2014 to October 2020, a total of 24 consecutive patients with retrograde type A IMH with intimal disruption (intimal tear or ulcer-like projection) in the descending aorta underwent TEVAR. The demographics, clinical characteristics, treatment details, imaging information, and follow-up results were reviewed. Results: Among all patients with retrograde type A IMH, 13 (54.2%) patients presented with ulcer-like projection and 11 (45.8%) with intimal tear (aortic dissection) in the descending aorta. Successful TEVAR was achieved in all patients. There was no 30-day mortality. During a mean follow-up of 37.5 months, 1 patient (4.2%) developed permanent paralysis, 1 patient (4.2%) underwent reintervention due to the expansion of the aorta distal to the stent resulting from the enlargement of distal intimal tear at the 2 month follow up, and no other adverse events were observed. The latest computed tomographic angiography images showed that the maximum diameter of the ascending aorta and descending aorta significantly decreased after TEVAR (both p<0.001), and the IMH/false lumen in the ascending aorta and the descending thoracic aorta were completely absorbed. Conclusion: Thoracic endovascular aortic repair for selected patients with retrograde type A intramural hematoma that presented with intimal disruption in the descending aorta is feasible and efficient, but close surveillance is needed to manage aortic-related adverse events.

Acute retrograde type A intramural hematoma treated with an endovascular approach

2018 ◽  
Vol 26 (4) ◽  
pp. 308-310 ◽  
Author(s):  
Anh T Vo ◽  
Khoi M Le ◽  
Trang T Nguyen ◽  
Thanh T Vu ◽  
Thien T Vu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Intramural Hematoma ◽  
Type A ◽  
Sudden Onset ◽  
Ascending Aorta ◽  
Acute Type ◽  
Descending Aorta ◽  
Severe Chest Pain ◽  
Endovascular Approach

A 71-year-old woman was admitted with sudden onset of severe chest pain. Computed tomography demonstrated acute type A intramural hematoma with an entry tear in the first part of the descending aorta. The patient refused an operation. Endovascular repair was performed to prevent conversion to a typical dissection of the ascending aorta. At the 1-year follow-up, computed tomography showed total resolution of the intramural hematoma.

scholarly journals Temporoparietal Headache as the Initial Presenting Symptom of a Massive Aortic Dissection

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Manan Parikh ◽  
Abhinav Agrawal ◽  
Braghadheeswar Thyagarajan ◽  
Sayee Sundar Alagusundaramoorthy ◽  
James Martin
Keyword(s):  
Aortic Dissection ◽  
Intramural Hematoma ◽  
Acute Onset ◽  
Ascending Aorta ◽  
Medical Emergency ◽  
Descending Aorta ◽  
Severe Chest Pain ◽  
Hemodynamic Compromise ◽  
Life Threatening ◽  
Prompt Diagnosis

Aortic dissection is a life-threatening medical emergency often presenting with severe chest pain and acute hemodynamic compromise. The presentation of aortic dissection can sometimes be different thus leading to a challenge in prompt diagnosis and treatment as demonstrated by the following presentation and discussion. We present a case of a 71-year-old male who presented to the emergency department with complaints of left sided temporoparietal headache and was eventually diagnosed with a thoracic aortic dissection involving the ascending aorta and descending aorta, with an intramural hematoma in the descending aorta. This case illustrates the importance of keeping in mind aortic dissection as a differential diagnosis in patients with acute onset headaches in which any intracranial source of headache is not found.

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