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Branch involvement at aortography in dissecting aneurysm, with particular reference to the lower intercostal and renal arteries.

Summary 
 
The changes in branch arteries at various levels, a frequent aortographic finding in 17 personal cases of aortic dissection, are described in detail and noted often to parallel those in the aorta itself. The mechanisms for their production are analysed fully. It is shown that impairment of functional integrity does not necessarily accompany apparent compromise of the blood supply of kidneys and other viscera and that the grosser renal artery changes are best assessed by correlation with renal function as observed during aortography. It is emphasized that the pronounced tendency to involvement of the left renal artery noted in this and earlier series is determined by the common anatomical path followed by most dissections, as is the high incidence of coexistent left lower intercostal and left renal artery changes here. The practical significance of the detection of branch involvement and of its correct interpretation is stressed.