Bidirectional Circumferential Intimo-Intimal Intussusception in Acute Aortic Dissection.

Complete circumferential aortic dissection with bidirectional intimo-intimal intussusception is a rare occurrence in Stanford type A dissections. The antegrade dissection flap can obstruct the left ventricular outflow tract and coronary sinuses, whereas the retrograde flap can obstruct the aortic arch and branch vessels. Sequelae include aortic regurgitation, myocardial ischemia, and neurologic complications. This case series highlights the need for prompt diagnosis with electrocardiography-gated computed tomography and surgical intervention for this unique pathologic process.