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L L ’ ’ Aorte Abdominale Aorte Abdominale - - B B - - Michel Dauzat, Jean-Pierre Laroche

L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

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Page 1: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

LL’’Aorte AbdominaleAorte Abdominale-- BB --

Michel Dauzat,Jean-Pierre Laroche

Page 2: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection AortiqueDissection Aortique

� Dissection de l’aorte thoracique� Étendue à l’aorte abdominale� Anomalie de modulation du flux :

encoche proto-systolique� Thrombose

Page 3: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Dissection aortique « récente »

Aorte abdominale juxta-rénale

Tracé Doppler

Page 4: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Dissection aortique « récente »

Artères Rénales

Tracé Doppler

Artère Mésentérique Supérieure

G

D

Page 5: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Modulation du Flux dans les chenaux

Page 6: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Modulation du Flux : Encoche Proto-Systolique

Tronc Coeliaque A. Mésentérique Sup.

Page 7: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Dissection aortique type III + 1 an

Artère Rénale Droite Artère Rénale Gauche

Page 8: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Dissection aortique type III + 1 an

Chenal latéral droit Chenal latéral gauche

Page 9: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Dissection aortique type III + 1 an

Coupe transversale Coupe longitudinale

(Imagerie Harmonique)

Page 10: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Dissection aortique à 3 ans

Lambeau intimal

Tracés Doppler

Page 11: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Dissection aortique « ancienne »

Aorte abdominale basse

Tracé Doppler

Page 12: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Dissection aortique « ancienne »Aorte abdominale Coupe longitudinale

Page 13: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Dissection aortique « ancienne »

Aorte abdominale Coupe transversale

Aorte abdominale Coupe longitudinale

Page 14: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Dissection aortique « ancienne »

Aorte abdominale Coupe transversale

Aorte abdominale Coupe longitudinale

Page 15: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Dissection aortique ancienne: sténose de l’artère coeliaque

Page 16: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Pic systolique bifide dans le chenal antérieur

Page 17: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Début d’ectasie de l’aorte abdominale haute sur ectasie

ancienne

Page 18: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Evolution ectasiqued’une dissection aortique (2 ans)

Page 19: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Evolution d’une dissection aortique(3 ans)

Page 20: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Evolution d’une dissection aortique(3 ans)

Page 21: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Evolution d’une dissection aortique(3 ans)

Page 22: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Evolution d’une dissection aortique(3 ans)

Page 23: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Evolution d’une dissection aortique(3 ans)

Page 24: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Evolution d’une dissection aortique(3 ans)

Page 25: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Abdominal Aorta Abdominal Aorta DissectionDissection

Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the left common iliac artery, in a patient with a 15 y.o. liver transplant. B-Flow demonstrates (for the first time during the follow-up) a very small and tortuous communication between the two channels in the distal abdominal aorta.

Aorta

Coeliac

Artery

Superior

Mesenteric Artery

Intimal Flap

B-Mode

Page 26: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Abdominal aorta

Right Iliac

Artery

Left IliacArtery

Secondary

orifice

Intimal Flap

Abdominal Abdominal Aorta Aorta

DissectionDissection

Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the left common iliac artery, in a patient with a 15 y.o. liver transplant. B-Flow demonstrates (for the first time during the follow-up) a very small and tortuous communication between the two channels in the distal abdominal aorta.

B-Flow

Page 27: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Thrombose de l’aorte en

aval de l’artère

rénale droite

Page 28: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Dissection Aortique

Thrombose de l’aorte en aval de l’artère rénale droite

Page 29: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Occlusion AortiqueOcclusion Aortique

� Sur Lésions Athéromateuses� Par Embolie� Maladie de Takayasu�Thrombose

Page 30: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Occlusion Aortique

Pré-occlusion de l’aorte terminale (A)

Page 31: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Occlusion Aortique

Pré-Occlusion de l’aorte terminale (B)

Aorte basse et artère Mésentérique inférieure

Artère Iliaque commune gauche

Page 32: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Occlusion Aortique

Pré-Occlusion de l’aorte terminale (C)

Chenal résiduel

Page 33: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Embolie et Occlusion

Occlusion par Embolie et l’aorte terminale et l’artère iliaque commune gauche

Page 34: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Embolie et Occlusion

Paroi irrégulière, lumière échogène, absence de flux

Occlusion athéromateuse de l’aorte sous-rénale :

Page 35: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Embolie et Occlusion

Flux anormal dans l’aorte sus-rénale

Occlusion athéromateuse de l’aorte sous-rénale

Réinjection de l’artère iliaque droite par l’artère

sacrale moyenne

Page 36: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Thrombose

Thrombus partiel de l’aorte abdominale haute (Thalassémie ?)

Page 37: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Thrombose

Thrombus partiel de l’aorte abdominale haute (Thalassémie ?)

Page 38: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Thrombose

Thrombus total de l’aorte abdominale sous-rénale

Page 39: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Thrombose

Thrombus total de l’aorte abdominale sous-rénale

Page 40: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Thrombose

Thrombus total de l’aorte abdominale sous-rénale

Page 41: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Thrombose

Thrombus total de l’aorte abdominale sous-rénale

Page 42: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Thrombose

Thrombus total de l’aorte abdominale sous-rénale

Page 43: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Contrôle aprContrôle aprèès s InterventionIntervention

� Pontages et prothèses• Etat des anastomoses• Diamètre• Perméabilité (vitesse, débit ?)

� Angioplastie� Stent

Page 44: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Contrôle post-chirurgical

Prothèse Aortique

Page 45: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Pontage

Pontage Aorto-bifémoral

Page 46: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Pontages et Prothèses

Prothèse Aortique

Page 47: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Pontages et Prothèses

Pontage Aorto-Fémoral – Anastomose Proximale

Page 48: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Autres AnomaliesAutres Anomalies

� Dolicho-Aorte� Compression� Refoulement� Variantes anatomiques

Page 49: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Aorte Sinueuse et Dolicho-Aorte

Aorte sinueuse

Page 50: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

Aorte Sinueuse et Dolicho-Aorte

Boucle Aortique

Page 51: L’Aorte Abdominale - B -...Abdominal Aorta Dissection Type III Aortic dissection (since 12 years) extended to the whole length of the abdominal aorta and the proximal part of the

LL’’Aorte AbdominaleAorte Abdominale

Michel Dauzat,Jean-Pierre Laroche

Suite : Artères de l’appareil digestif


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