PMC2515435_01
Echocardiogram: no intimal flap is present.
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fig1
CT-Angio without gating. Pulsation artifacts misappared of aortic valve (a-c) and aortic arch thrombus (MPR: b); suspected ascending aorta intimal flap (MPR: c)
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fig2
CT angiography suspected an intimal flap of ascending aorta, involving aorta valve and with possible involvement coronary artery ostium (Figure 2 a-c); also a possible thrombosed intimal tear of aorta arch was considered (Figure 2 b).
CT-Angio ECG-gated. Excluded aortic valve dissection (a), showed thrombus of innominate trunk, left common carotid artery and left subclavian artery (b-c).
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fig3
Virtual Endoscopy (3D EV): confirmed extension of aorta arch thrombus.
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fig4
a-b Volume Rendering (3D VR): CT-Angio after sovraortic vessels debrunching.
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fig5
The subclavian artery, the left carotid artery and the innominate artery were connected one by one to the graft (Figure 5 a-b).