Demonstration of entry tear and disrupted intima in asymptomatic chronic thrombosed type B dissection with non-obstructive angioscopy

Description 

A 49-year-old man was referred to our hospital for atypical chest pain, without severe abdominal or back pain. He had a history of smoking and dyslipidaemia. His ECG showed no ST-T elevation. Coronary CT angiography (CTA) suggested moderate left anterior descending artery stenosis. CTA screening for aortic atherosclerosis showed significant calcification (figure 1A) and a crescent-shaped, mural low-density area in the infrarenal abdominal aorta (figure 1B,C). This was thought to be an intramural haematoma or a thrombosed false lumen. Calcified spots were deposited at the boundaries between the lumen and the low-density area (figure 1B,C). An intramural haematoma or a thrombosed type B dissection can be asymptomatic. Invasive coronary angiography showed no significant stenosis.

Figure 1

CT angiography images of the aorta. (A) Maximum intensity projection. Calcification deposited in the infrarenal abdominal aorta; however, a few calcifications were found in other sections....

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