Intimo-intimal intussusception and other unusual manifestations of aortic dissection

Acute Aortic Dissection with Intimal Intussusception: MRI Appearances

“…Because the intussuscepted flap can partly occlude the aortic arch and the brachiocephalic arteries, neurologic manifestation may be more frequent. Of the 12 cases reported with intimointimal intussusceptions, eight (67%) had neurologic signs and symptoms on presentation [1][2][3][4][5][6][7][8][9]. The same neurologic symptoms appeared in the patient presented here.…”

“…Intimointimal intussusception is an unusual type of acute aortic dissection in which the intimal tear occurs circumferentially with intussusception of the intima downstream. Since Hufnagel and Conrad [1] described the first case in 1962, fewer than 15 cases have been reported in the literature [1][2][3][4][5][6][7][8][9]. The preoperative diagnosis is important to allow for appropriate surgical planning [3], but there may sometimes be difficulties in reaching the appropriate diagnosis due to lack of the classic echocardiographic and CT signs of a type A aortic dissection [9].…”

“…The same neurologic symptoms appeared in the patient presented here. In addition, it was very difficult for the catheter to pass beyond the aortic arch during aortography [1,2,[6][7][8]. An aortogram showed a dilated ascending aorta, a curvilinear or a windsock linear filling defect in the aortic arch, and partially occluded arch vessels [2,3,6].…”

“…ntimointimal intussusception is an unusual type of acute aortic dissection, with fewer than 15 cases reported in the English-language literature [1][2][3][4][5][6][7][8][9]. Several reports have described the findings of aortography [1-3, 6, 8], transesophageal echocardiography (TEE) [4,5,8,9], and CT [6][7][8][9], but the MRI findings, to our knowledge, have not been reported.…”

Intimal Dehiscence in the Abdominal Aorta Following Balloon Fenestration for Type B Dissection

“…Aortic intimal dehiscence, defined as intimal separation from the media over the entire circumference of the aorta, is an uncommon entity that typically occurs spontaneously as a complication of dissections starting in the ascending aorta. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Only in the case described by Karabulut et al 11 was the dissection continuous in the descending thoracic aorta. Circumferential intimal tears in type A dissec-tions are said to predispose to intimointimal intussusception.…”