Balloon was inflated and burst into false lumen
. Post procedure BP was 140/70 and his Pulse was 84 in sinus rhythm.
Two pathogenic mechanisms of SCAD have been described: (i) the intimal tear hypothesis, whereby an interruption in the intimalluminal interface forms an entry point for intramural haematoma accumulation inside the false lumen
, leading to separation of the arterial wall; and (ii) the medial haemorrhage hypothesis that postulates that bleeding into the arterial wall due to spontaneous rupture of the vasovasorum is the primary pathogenic mechanism.
Initially, the femoral artery approach for the SMA dissection stenting was attempted multiple times, but every time, the probe went into the false lumen
of dissection as it was directed distally toward the descending aorta.
DSA demonstrated the re-routed blood fow to the true aortic lumen and no leak to the false lumen
at the thoracic aortic segment (Fig.
Thrombus may form on the injured intimal lining, or within a pseudoaneurysm, false lumen
, or markedly narrowed true lumen.
Intracoronary imaging can also verify adequate obliteration of the false lumen
and compression of the intramural hematoma after the stent has been placed [29, 30].
Aortic dissection is a life-threatening emergency with high mortality, caused by an intimal and medial tear in the aorta, with formation of a false lumen
within the aortic media.
The extension of false lumen
may cause a narrowing in the true lumen, and diminished renal blood flow may cause renal infarct.
Follow-up CT scanning of the aorta after 35 days showed no early false lumen
The main reason for this disease is that tissue weakness and high blood pressure lead to one or more aortic tissues perforation(s), blood flow along the intimae resulting in two separate blood flow channels: the true lumen (the primary aorta bed of blood flow) and the false lumen
(a channel entirely within the media which appears during an aortic dissection) , as shown in Figure 1.
Parameters suggested to be associated with higher risk of aortic expansion include patient age, total aortic diameter, false lumen
diameter, greater primary entry tear diameter, primary entry tear location, and false lumen
thrombosis [1, 5, 7-10].