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Acute Aortic Dissection With Carotid and Coronary Malperfusion: From Imaging to Pathology

Lardi, Christelle MD*; Lobrinus, Johannes-Alexander MD; Doenz, Francesco MD; Fracasso, Tony MD, PD*; Augsburger, Marc PhD; Mangin, Patrice MD, PhD; Grabherr, Silke MD, PD§

The American Journal of Forensic Medicine and Pathology: September 2014 - Volume 35 - Issue 3 - p 157–162
doi: 10.1097/PAF.0000000000000098
Case Reports

Postmortem imaging, including postmortem computed tomography angiography, has become an integral tool in forensic investigation in recent years. A relatively new technique, multiphase postmortem computed tomography angiography, allows detailed visualization of the vascular system and makes it possible to evaluate the dynamic perfusion of aortic branches, including the coronary arteries. Here, we report a case of aortic dissection involving the ascending aorta (type A) with coronary and carotid malperfusion. This case illustrates the complementary use of many of the diagnostic tools that are now available in forensic practice, from imaging to conventional autopsy to pathologic techniques such as immunohistochemistry.

From the *University Center of Legal Medicine Lausanne-Geneva, Geneva University Hospitals; †Department of Pathology, Geneva University Hospitals, Geneva; ‡Department of Diagnostic and Interventional Radiology, University Hospital of Lausanne; and §University Center of Legal Medicine Lausanne-Geneva, University Hospital of Lausanne, Lausanne, Switzerland.

Manuscript received October 2, 2013; accepted December 1, 2013.

This study was funded by the Promotion Agency for Innovation of the Swiss Confederation (KTI Nr.10221.1 PFIW-IW) and by the Fondation Leenaards, Lausanne, Switzerland.

The authors report no conflicts of interest.

Reprints: Christelle Lardi, MD, University Center of Legal Medicine Lausanne-Geneva, Geneva University Hospitals, Michel-Servet 1, CH-2011 Geneva 4, Switzerland. E-mail:

© 2014 by Lippincott Williams & Wilkins.