Unusual complication of aortic dissections: intimo–intimal i
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Intimo–intimal intussusception is a rare but fatal complication of aortic dissection. Emergency surgery is a life-saving procedure in aortic dissection. Intimo–intimal intussusception is an atypical manifestation of aortic dissection produced by circumferential dissection of the media and intimal layer of the aorta and invagination of the intimal flap in the aortic arch in DeBakey type I and type II aortic dissections.

Due to the absence of the intimal flap and crescent sign in the ascending aorta, it is difficult to diagnose this condition. A definitive diagnosis is made on transoesophageal echocardiography (TEE) with the observation of a prolapse of the dissection flap into the ascending aorta. Delaying the diagnosis may result in delayed treatment and increased risk of mortality. We present our case with a literature review of diagnosis and treatment of intimo-intimal intussusception.

Case report
Angiography was performed for a pre-diagnosis of acute coronary syndrome in this case presenting to a cardiology centre with symptoms of syncope and chest pain lasting for three days. She was referred to our clinic with a pre-diagnosis of type III aortic dissection since a catheter had been placed into the false lumen and it could not be advanced into the aortic arch.

The 76-year-old female patient was admitted for the purpose of investigation and treatment. It was learned from her history that she had had hypertension for 10 years, and had been receiving treatment for 15 years for diabetes mellitus. On physical examination, she had poor consciousness with a poor general condition and a tendency to sleepiness. Her blood pressure and pulse rate were determined at 180/100 mmHg and 120 beats/min, respectively. Her left radial pulse was absent....