Management of Isolated Abdominal Aortic Dissection: Indications and Strategies for Treatment

Ann Vasc Surg. 2024 Feb:99:117-124. doi: 10.1016/j.avsg.2023.09.081. Epub 2023 Nov 14.

Abstract

Background: The aim of this paper was to report our experience in the management of isolated abdominal aortic dissection with endovascular aortic repair and conservative treatment.

Methods: A cohort of 22 consecutive patients with isolated abdominal aortic dissection was treated between January 2016 and December 2021. We reviewed the demographics, clinical features, therapeutic modalities and follow-up results. Retrospective data analysis from patient charts was performed.

Results: Twenty-two patients were enrolled in this study from 2 centers. The mean age was 66.2 ± 13.3 years. Hypertension was the primary risk factor. Seventeen (72.7%) patients were asymptomatic, and 18 patients were subrenal artery type (type II). A total of 12 patients had successful endovascular repair (EVAR), and 10 patients underwent conservative treatment. In the group receiving conservative treatment, no patients required EVAR during follow-up, and 4 patients died. However, none of them had aortic causes: 2 patients had cardiac causes, the other 2 had cancer, and the others remained symptom-free. The latest computed tomographic angiography images showed that abdominal aortic dissection still existed, and the extent of the false lumen did not increase significantly.

Conclusions: Both conservative treatment and EVAR are effective treatment options. Appropriate treatment needs to be performed according to different patients' clinical manifestations and doctors' experience.

Publication types

  • Review

MeSH terms

  • Aged
  • Aortic Aneurysm, Abdominal* / diagnostic imaging
  • Aortic Aneurysm, Abdominal* / etiology
  • Aortic Aneurysm, Abdominal* / surgery
  • Aortic Dissection* / diagnostic imaging
  • Aortic Dissection* / surgery
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Dissection, Abdominal Aorta*
  • Endovascular Procedures* / adverse effects
  • Endovascular Procedures* / methods
  • Humans
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome