Reference Work Entry

Encyclopedia of Intensive Care Medicine

pp 2396-2397

Vascular, Intimal Flap

  • David V. FelicianoAffiliated withDepartment of Surgery, Emory University School of Medicine, Grady Memorial Hospital Email author 


An intimal flap in an artery can also be described as an intraluminal flap or wall defect in an artery


The wall of an artery is composed of a tunica intima, tunica media, and a tunica adventitia. The intima is the innermost layer of an artery (or vein) and is composed of endothelium (the cells lining the lumen), a subendothelial layer of connective tissue, and an elastica interna. Either blunt or penetrating trauma can lead to a tear in the endothelium and other layers of the intima. A piece of intima still attached to the media may result and will project into the lumen of the artery as an intimal flap.

Blunt trauma to a patient is a more common cause of a vascular intimal flap than penetrating trauma. Deceleration-type trauma or a side impact in a motor vehicle crash can lead to disruption of the intima alone or intima and media of the descending thoracic aorta just distal to the ligamentum arteriosum. With an intact media or media and adventitia, the ...

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