Aortic intramural hematoma (IMH) is a relatively rare, but potentially fatal pathology, which is most commonly diagnosed under emergency conditions with computed tomography angiography (CTA). We present two cases of IMH examined with different CTA protocols, which resulted in diverse diagnoses.In the first patient, contrast-enhanced CTA revealed dilatation of thoracic aorta and polymorphic wall thickening. It was misdiagnosed as being a mural thrombus and was complicated by acute dissection. In the second patient, non-enhanced CT revealed hyperdense aortic wall thickening. The patient was diagnosed as having type B IMH but he died due to aortic rupture.In our opinion, CT examination of the aorta in emergency cases should always include non-enhanced scanning. Any delay in proper diagnosis and treatment of IMH may result in serious complications.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3389901 | PMC |
Publication Analysis
Top Keywords
Similar Publications
Hybrid Repair of Ascending Aortic Intramural Hematoma and Arch Ulcer in a 74-Year-Old Woman - A Case Report.
Am J Case Rep
January 2025
Department of Cardiovascular Surgery, Fujian Heart Medical Center, Union Hospital, Fujian Medical University, Fuzhou, Fujian, China.
BACKGROUND Acute intramural hematoma (IMH) of the ascending thoracic aorta and aortic arch is a life-threatening condition, particularly in elderly patients with comorbidities, due to its risk of progression and rupture. Unlike aortic dissection, IMH lacks an intimal tear, influencing both clinical presentation and treatment strategy. This report describes a 74-year-old hypertensive woman with type A IMH and a penetrating atherosclerotic ulcer (PAU), managed with a hybrid surgical approach that combines external Dacron wrapping of the ascending aorta and endovascular stenting of the aortic arch with in-situ fenestration of the supra-aortic arteries.
View Article and Find Full Text PDFImages in Vascular Medicine: Naked and clothed right coronary artery in aortic intramural hematoma.
Vasc Med
January 2025
Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.
Adult congenital aortic coarctation complicated by acute type a aortic intramural hematoma treated with a staged hybrid technique: a case report.
J Cardiothorac Surg
January 2025
Department of Cardiovascular Surgery, Qingdao Municipal Hospital, Qingdao, 266000, China.
Background: Coarctation of the aorta (CoA) in adults is rare. usually combined with dilatation of the ascending aorta. Further disease progression complicated by hematoma or dissection of the ascending aorta is even more complicated and dangerous.
View Article and Find Full Text PDFInitial Multicenter Experience With the New Castor Arch Branched Device in Europe: A Middle-term Results Study.
J Endovasc Ther
December 2024
Department of Vascular Surgery, General Surgery and Angiology, Pomeranian Medical University, Szczecin, Poland.
Background: Published reports demonstrate that the use of Castor stent-graft is a promising treatment of aortic pathologies with the need to land in zone 2. However, there is a lack of publications on the medium-term results of Castor in the European population. This research evaluates the mid-term results of the Castor stent-graft in several Polish centers for the treatment of aortic pathologies and enriches the current knowledge of Castor stent-grafts.
View Article and Find Full Text PDFInterpretation of intra-operative strain differences in ascending thoracic aortic repair patients.
J Biomech
January 2025
Department of Cardiothoracic Surgery, CARIM School for Cardiovascular Diseases, Heart & Vascular Centre, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands. Electronic address:
Local biaxial deformation plays a pivotal role in evaluating the tissue state of the ascending aorta and in driving intramural cell-mediated tissue remodeling. Unfortunately, the absence of anatomical markers on the ascending aorta presents challenges in capturing deformation. Utilizing our established intra-operative biaxial strain measurement method, we delineated local biaxial deformation characteristics in patients undergoing aortic valve replacement and coronary artery bypass graft surgery recipients (n = 20), and Aortic Repair surgery patients (n = 47).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!