Exploring inside a shaggy aorta using non-obstructive angioscopy

A shaggy aorta is reportedly related to atheromatous embolisation, which causes serious ischaemic damage to various organs. However, its characteristics are poorly understood. Non-obstructive angioscopy (NOA) has been developed to safely detect aortic plaques and injuries. A 70-year-old woman who was found to have a shaggy aorta on CT angiography underwent NOA for precise evaluation of vulnerable aortic plaques and injuries inside the aorta. Vulnerable aortic plaques included puff-like ruptures, chandelier-like ruptures and erosions seen throughout the aorta. Aortic injuries included flaps, slits, subintimal bleeding, dissection and multilayered partitions. The patient had no embolic symptoms or an elevated eosinophil count, estimated glomerular filtration rate or C reactive protein level, compared with the baseline. Various changes in spontaneous vulnerable plaques and injuries inside the aorta that were not apparent on CT were safely revealed on NOA. Thus, NOA may reveal findings indicative of spontaneous and postoperative atheromatous embolisation.