Branch vessel occlusion often complicates aortic dissection. The occlusion may result from orifice occlusion and distal thrombosis, from dissection into the branch, or from intimal separation and thrombosis of the false lumen. Occlusions may result in stroke, spinal cord ischemia, renal failure, mesenteric ischemia and lower extremity ischemia. As the illustrated case points out, dissection can mimic other acute ischemia events. It should be considered in the differential diagnosis of any patient suffering acute illness involving different organ systems and pulse deficits. (See comments).
As soon as this patient's dissection was studied and characterized as type A, he was taken to the operating room by cardiothoracic surgery. The ascending aorta was dilated with obvious intramural blood. Proximal and distal control was obtained.
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