Related Experiment Video

Updated: May 12, 2026

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
06:26

Novel and Innovative Hybrid Technique for Type A Aortic Dissection

Published on: March 28, 2025

Aortic intussusception complicating diagnostic angiography: recognition and management

Anika L Mirick1, Himanshu J Patel, G Michael Deeb

  • 1Department of Radiology, and Cardiothoracic Surgery, University Hospitals, University of Michigan, Ann Arbor, MI 48109-0030, USA.

The Annals of Thoracic Surgery
|April 24, 2013
PubMed

Insights

Aortic dissection repair during diagnosis led to an intimal flap complication. Balloon fenestration and stenting successfully restored blood flow in this Marfan syndrome case.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Marfan syndrome predisposes individuals to aortic complications, including aortic dissection.
  • Diagnostic catheterization carries inherent risks, particularly in patients with pre-existing aortic pathology.
  • Acute type B aortic dissection presents a significant challenge for vascular interventions.

Observation:

  • During diagnostic evaluation for Marfan syndrome and type B aortic dissection, a catheter inadvertently engaged the dissection entry tear.
  • Catheter traction caused extensive intimal flap dehiscence, leading to intimal intussusception and occlusion of the true lumen.
  • This complication resulted in critical obstruction of visceral and renal arteries.

Findings:

  • A novel approach involving balloon fenestration of the intimal flap was performed.
  • Supramesenteric stenting of the true lumen was utilized to manage the intimal intussusception.
  • The intervention successfully decompressed the intimal flap and restored perfusion to the visceral and renal arteries.

Implications:

  • This case highlights a rare but serious complication during aortic dissection evaluation.
  • Demonstrates the efficacy of balloon fenestration and stenting in managing complex intimal flap complications.
  • Suggests a potential endovascular strategy for similar iatrogenic aortic injuries.

Related Concept Videos

Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
Aneurysm I: Introduction01:30

Aneurysm I: Introduction

An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...