Page 46 - Virtual Vascular Vol 4
P. 46

Type B Aortic Dissection with                                                                                                                               Intimal tear distal


      left renal malperfusion                                                                                                                                     to left subclavian artery







        A 50 years old gentleman with history of hypertension complained of

        acute onset of chest pain 2 months ago which subsided gradually, and he

        did not seek medical attention. He had poor drug compliance all along.
        His blood pressure remains difficult to control and on 4 anti-

        hypertensives drugs to maintain systolic blood pressure <140mmHg. His                                                                                                       Coeliac artery

        Creatinine was 140mmol/l. CT aortogram showed Stanford Type B aortic                                                                                                        from false lumen
        dissection distal to left subclavian artery. The celiac artery was perfused

        from the false lumen, superior mesenteric artery was from both true and

        false lumen, right renal artery from true lumen and left renal artery from
        false lumen. The left kidney was small and hypoperfused.






















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                                                                                                                                                             right renal artery from true lumen
        46                                                                                                                                                   left renal artery from false lumen                                       47
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