Shaggy Aorta Syndrome after Cerebral Angiography: A Case Report

Area of Science:

• Cardiovascular Imaging
• Neurology
• Vascular Medicine

Background:

• Shaggy aorta is characterized by intimal roughening from atheromatous plaques.
• Complications include cholesterol emboli and systemic organ infarction after procedures like catheterization.
• Diagnosis often involves contrast-enhanced computed tomography (CT) and transesophageal echocardiography.

Purpose of the Study:

• To report a case of shaggy aorta syndrome following transfemoral cerebral angiography.
• To highlight the diagnostic challenges and clinical presentation.
• To propose preprocedural screening using aortic MRI.

Main Methods:

• A case report of an elderly patient with a history of stroke and carotid stenosis.
• Diagnostic imaging included brain MRI and contrast-enhanced CT.
• Follow-up included aortic MRI to assess plaque stability.

Main Results:

• The patient developed dysarthria and finger ischemia post-cerebral angiography.
• Contrast-enhanced CT confirmed shaggy aorta.
• Aortic MRI revealed an unstable plaque, suggesting a link to the embolic events.

Conclusions:

• Shaggy aorta syndrome is a potential complication of cerebral angiography, particularly in patients with severe atherosclerosis.
• Early diagnosis and management are crucial.
• Preprocedural aortic fast spoiled gradient echo MRI screening may help prevent shaggy aorta syndrome in at-risk patients.