Aortic Dissection

Thoracic aortic dissection

Chest PA

Lt.pleural effusion.
increased descending aorta diameter.
-r/o aortic dissection

Chest CT

Type B aortic dissection with rupture at distal thoracic aorta level.
bleeding foci from intercostal arteries. Passive atelectasis, LLL..
Celiac axis, SMA and bilateral renal arteries from true lumen

Aortogram

It revealed a descending thoracic aortic dissection with the intimal tear and large amount shunt to false lumen.

IVUS

IVUS is useful to identify a true(T) and false lumen(F), especially tear site of intima(arrow). Tue lumen was collapsed due to large false lumen. And it’s helpful to decide the size of stent graft.

Follow-up aortogram showed good apposition without endo-leakage. IVUS was done via left common femoral artery.