CTICasesAortic Dissection with Intimal Intussusception
Imaging findings
CT angiography shows a circumferential intimal-medial tear of the proximal ascending aorta. The dissected intimal flap has prolapsed distally into the aortic arch, creating a 'windsock' or sleeve-like intimal intussusception that causes transient obstruction of the arch vessels.
Key takeaways
Circumferential aortic dissection is a rare and life-threatening variant where the intima-media tear is complete and circumferential. The blood flow pushes the detached sleeve of intima distally (intussusception), which can cause catastrophic obstruction of the arch branches (coronary, head/neck vessels). ECG-gated CT is vital to distinguish this from motion artifact.
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