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Aortic cobwebs: an anatomic marker identifying the false lumen in aortic dissection--imaging and pathologic
D M Williams1, A Joshi, M D Dake
1Department of Radiology, University Hospitals, Ann Arbor, MI 48109-0030.
Radiology
|January 1, 1994
Summary
Aortic cobwebs, or fibroelastic cords, are remnants of aortic dissection. These structures are identified in pathology and imaging, aiding in false lumen visualization for interventions.
Area of Science:
- Cardiovascular Imaging
- Pathology
- Aortic Diseases
Background:
- Aortic dissection involves a tear in the aorta, creating a false lumen.
- Fibroelastic cords, termed "aortic cobwebs," can form within the false lumen.
Purpose of the Study:
- To describe and determine the frequency of aortic cobwebs in acute and chronic aortic dissections.
- To evaluate the utility of aortic cobwebs as an anatomic marker.
Main Methods:
- Review of 23 pathologic specimens and 38 imaging studies (MR, intravascular US, transesophageal US) from 43 patients.
- Assessment of the presence and configuration of aortic cobwebs.
Main Results:
- Aortic cobwebs were identified in 17/23 (74%) pathologic specimens and in imaging studies.
- Cobwebs typically bridge the dissection flap and outer wall, or project from the false lumen wall.
- Found in 74% of specimens and on MR, intravascular US, and transesophageal US.
Conclusions:
- Aortic cobwebs are likely incompletely sheared media remnants, serving as an anatomic marker for the false lumen.
- Their occasional visualization on routine imaging may aid orientation during interventional procedures for aortic dissection complications.