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Exploring inside a shaggy aorta using non-obstructive angioscopy.

Sei Komatsu¹, Satoru Takahashi¹, Yasuyuki Toyama¹

¹Cardiovascular Center, Osaka Gyoumeikan Hospital, Osaka, Japan.

BMJ Case Reports

|May 25, 2017

Summary

A shaggy aorta, linked to atheromatous embolisation, has poorly understood characteristics. Non-obstructive angioscopy (NOA) safely revealed detailed aortic plaques and injuries, offering new diagnostic insights.

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Area of Science:

Cardiovascular Medicine
Vascular Imaging
Interventional Cardiology

Background:

A shaggy aorta is associated with atheromatous embolisation, potentially causing organ ischaemia.
The specific characteristics and diagnostic challenges of a shaggy aorta remain incompletely understood.
Non-obstructive angioscopy (NOA) offers a safe method for detecting aortic plaques and injuries.

Observation:

A 70-year-old woman with a shaggy aorta underwent NOA for detailed evaluation.
NOA identified various vulnerable aortic plaques, including puff-like and chandelier-like ruptures and erosions.
Aortic injuries such as flaps, slits, subintimal bleeding, dissection, and multilayered partitions were visualized.

Findings:

NOA revealed diverse spontaneous changes in aortic plaques and injuries not visible on CT angiography.

Keywords:

Cardiovascular medicine Interventional cardiology Interventional radiology

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The patient exhibited no embolic symptoms or significant changes in inflammatory markers or renal function.

Detailed characterization of aortic pathology was achieved through NOA.

Implications:

NOA provides a safe and effective method for precisely evaluating shaggy aorta characteristics.
This technique may enhance the understanding and diagnosis of spontaneous atheromatous embolisation.
NOA findings could be crucial for identifying risks associated with postoperative atheromatous embolisation.