Takahashi Satoru, Komatsu Sei, Ohara Tomoki, Takewa Mitsuhiko, Toyama Yasuyuki, Yutani Chikao, Kodama Kazuhisa
Cardiovascular Center, Osaka Gyoumeikan Hospital, Osaka, Japan.
Department of Pathology, Cardiovascular Center, Osaka Gyoumeikan Hospital, Osaka, Japan.
J Cardiol Cases. 2018 Jul 17;18(5):164-167. doi: 10.1016/j.jccase.2018.07.001. eCollection 2018 Nov.
A 73-year-old man reporting severe chest and back pain for 20 min was admitted to our hospital. The pain occurred 3 days before admission. Computed tomography angiography showed a hazy-surfaced low-density area in the aortic arch with aneurysmal formation of unknown etiology. It was inconclusive whether the aortic change was acute or chronic because no previous information was available. To investigate the etiology, non-obstructive angioscopy (NOA) was performed. A fissure with blood flow was detected at the surface of the low-density area and active subintimal blood flow was demonstrated on NOA. An entry tear and active blood flow below the intima at the seemingly thrombosed area suggested that the patient had a thrombosing type B aortic dissection. < A 73-year-old man reporting severe chest and back pain for 20 min was admitted to our hospital, occurring 3 days before admission. Computed tomography angiography (CTA) was inconclusive, showing a hazy-surfaced low-density area in the aortic arch with aneurysm formation. Non-obstructive angioscopy detected a disrupted intima, including entry of the dissection and active subintimal blood flow. The patient was diagnosed with thrombosed type B aortic dissection. Apparent flow inside the low-density area was missed on CTA.>.
一名73岁男性因胸痛和背痛20分钟前来我院就诊，疼痛于入院前3天出现。计算机断层血管造影显示主动脉弓处有一个表面模糊的低密度区域，伴有病因不明的动脉瘤形成。由于没有既往信息，无法确定主动脉病变是急性还是慢性。为了探究病因，进行了非阻塞性血管内镜检查（NOA）。在低密度区域表面检测到一条有血流的裂缝，并且在NOA上显示有活跃的内膜下血流。在看似血栓形成的区域，内膜处有一个入口撕裂和活跃的血流，提示该患者患有血栓形成型B型主动脉夹层。<一名73岁男性因胸痛和背痛20分钟前来我院就诊，疼痛于入院前3天出现。计算机断层血管造影（CTA）结果不明确，显示主动脉弓处有一个表面模糊的低密度区域伴有动脉瘤形成。非阻塞性血管内镜检查发现内膜破裂，包括夹层入口和活跃的内膜下血流。该患者被诊断为血栓形成型B型主动脉夹层。CTA遗漏了低密度区域内的明显血流。>
