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KMID : 0368120010310030347
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Korean Circulation Journal
2001 Volume.31 No. 3 p.347 ~ p.352
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A Case of Endovascular Stent-Graft Implantation in Aortic Dissection mimicking Intramural Hematoma in Descending Thoracic Aorta
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심대근/Dae Keun Shim
이병권/하종원/이도연/장병철/심원흠/Byoung Kwon Lee/Jong Won Ha/Do Yun Lee/Byung Chul Chang/Won Heum Shim
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Abstract
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Intramural hematoma(IMH) and penetrating aortic ulcer have been increasingly recognized as causes of acute aortic pathology in addition to aortic dissection. The presence of the intimal tear and a flap traversing the aortic lumen is considered to be a
most reliable differential point of aortic dissection and IMH. Transesophageal echocardiography(TEE) has become a valuable modality for the diagnosis, prognosis and management of acute aortic syndrome with the unique advantages of portability and the
ability to obtain high-resolution real time images. Endovascular Stent-graft placement over the primary entry tear may be an alternative to open surgery because it can close the intimal tear, which leads to thrombosis of the false lumen, excluding flow
through the intimal tear and redirecting aortic flow exclusively into the true lumen. We report 88 year-old male with aortic dissection in descending thoracic aorta, successfully treated with endovascular Stent-graft implantation, which was mimicking
intramural hematoma by its appearance and subclinical intimal tear diagnosed exclusively by TEE against other imaging studies.
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KEYWORD
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