CTICasesChronic Aortic Dissection with Multiple Small Fenestrations
Imaging findings
Thin-section CT angiogram with maximum intensity projection (MIP) reconstructions demonstrates a chronic aortic dissection involving the descending and abdominal aorta. Detailed evaluation reveals multiple tiny, subtle fenestrations along the dissection flap, seen as small, distinct jets of contrast opacifying the false lumen, which may correspond to avulsed intercostal arteries.
Key takeaways
Thin-section CTA and MIP reformats can help identify multiple tiny fenestrations along the dissection flap in chronic aortic dissections. The presence of these multiple small communications may explain why endovascular stenting sometimes fails to completely thrombose the false lumen in certain type B dissections.
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