Iatrogenic Aortic Root Injury from Coronary Interventions: Early and Follow-up CT Imaging Findings

Cappellini, Luca Alessandro; Eberhard, Matthias; Templin, Christian; Vogt, Paul; Manka, Robert; Alkadhi, Hatem

doi:10.1148/ryct.2021210241

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…The two cannot be completely distinguished by the onset-admission time, and their imaging manifestations are also very similar. Luca A et al [ 31 ]in the case report on iatrogenic aortic dissection, it was suggested that during CTA, when the intimal injury produced a small channel, the contrast medium would enter the aortic wall, and once the channel was closed, it would reexamine the appearance of aortic intramural hematoma on PCI a few days later. As Terrence D et al [ 32 ] said, iatrogenic AD often occurs in the form of IMH and may be a more focal process.…”

Section: Discussionmentioning

confidence: 99%

Clinical and imaging differences between Stanford Type B intramural hematoma-like lesions and classic aortic dissection

Wei

et al. 2023

BMC Cardiovasc Disord

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Background Intramural hematoma (IMH) and Aortic dissection (AD) have overlapping features. The aim of this study was to explore the differences between them by comparing the clinical manifestations and imaging features of patients with acute Stanford type B IMH-like lesions and acute Stanford type B AD (ATBAD). Methods This study retrospectively analysed the clinical and computed tomography angiography (CTA) imaging data of 42 IMH-like lesions patients with ulcer-like projection (ULP) and 38 ATBAD patients, and compared their clinical and imaging features. Results (1) The IMH-like lesions patients were older than the ATBAD patients (64.2 ± 11.5 vs. 50.9 ± 12.2 years, P < 0.001). The D-dimer level in the IMH-like lesions group was significantly higher than that in the ATBAD group (11.2 ± 3.6 vs. 9.2 ± 4.5 mg/L, P < 0.05). The incidence rate of back pain was significantly higher in the ATBAD group than in the IMH-like lesions group (71.1% vs. 26.2%, P < 0.05). (2) The ULPs of IMH-like lesions and the intimal tears of ATBAD were concentrated in zone 4 of the descending thoracic aorta. The ULPs of IMH-like lesions and the intimal tears of ATBAD were mainly in the upper quadrant outside the lumen (64.3% vs. 65.8%, P > 0.05). (3) The maximum diameter of the ULPs in IMH-like lesions was smaller than that of the intimal tears in ATBAD (7.4 ± 3.4 vs. 10.8 ± 6.8 mm, P = 0.005). The lumen compression ratio in the ULPs plane and the maximum compression ratio of the aortic lumen in the IMH-like lesions group were smaller than that in the ADBAD group (P < 0.05). Fewer aortic segments were involved in IMH-like lesions patients than in ATBAD patients (5.6 ± 2.2 vs. 7.1 ± 1.9 segments, P < 0.005). The IMH-like lesions group had less branch involvement than that of the ATBAD group (P < 0.001). Conclusion The degree of intimal tears, lumen compression ratio, extent of lesion involvement, and impact on branch arteries in ATBAD are more severe than that of IMH-like lesions. But for the ULPs of IMH-like lesions and intimal tears of ATBAD, they have astonishing similarities in the location of the partition and the lumen quadrant, we have reason to believe that intimal tear is the initial factor in the pathogenesis of this kind of disease, and their clinical and imaging manifestations overlap, but the severity is different. Concerning similarities between these two conditions, these two may be a spectrum of one disease.

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Section: Discussionmentioning

confidence: 99%

Clinical and imaging differences between Stanford Type B intramural hematoma-like lesions and classic aortic dissection

Wei

et al. 2023

BMC Cardiovasc Disord

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“…Although IMH is rare, it is a life-threatening disease of the aorta. It is most commonly diagnosed in elder men between the ages of 60 and 80 years [8][9][10]. It occurs in an area where the aorta is weakened; this can occur as a consequence of hypertension, atherosclerosis, Marfan syndrome, Takayasu's arteritis, prior aortic surgery, aortic aneurysm, coarctation of the aorta, bicuspid aortic valve, pregnancy and prior cardiac surgery [2].…”

Section: Discussionmentioning

confidence: 99%

A Typical Aortic Intramural Hematoma With an Atypical Neurological Presentation

Sidhu,

Waheed,

Sheikh

et al. 2023

Cureus

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Aortic intramural hematoma (IMH) is characterized by blood spilling through the intimal layer of the aortic wall without any tear within the aortic wall. The condition has been troublesome to analyze until of late. A 55-year-old gentleman with hypertension presented with epigastric pain radiating to the back, he later developed back pain as well as bilateral lower limb numbness and was found to have IMH when a CT angiogram was conducted. Due to the severity of the illness, the patient expired on the 10th day of the admission. It is important for physicians to be aware of atypical presentations of this life-threatening aortic disease.

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