Effectiveness of the conservative therapy for spontaneous isolated iliac artery dissection: Preliminary results

Abstract

Purpose To investigate the effectiveness of conservative therapy for spontaneous isolated iliac artery dissection (SIIAD). Methods From February 2006 to May 2016, all patients with SIIAD were included and analyzed. The diagnosis of SIIAD was made based on contrast-enhanced computed tomography. The imaging morphologic characteristics, treatments, and outcomes for each patient were analyzed. Results A total of 11 patients (10 male and 1 female, age 71.1 ± 7.8 years) were included in this study. Of the 11 patients, 8 patients were asymptomatic and the SIIADs were discovered during the course of computed tomography for other diseases, and 3 patients were symptomatic. Initial computed tomography findings: iliac arterial calcification ( n = 7); compression of the true lumen ( n = 6), with stenosis of the true lumen from 25% to 50% ( n = 3) and ≥ 50% ( n = 3); thrombosed false lumen partially ( n = 4), and no thrombosis in false lumen ( n = 7); dissecting aneurysm ( n = 11); entry points ( n = 11); re-entry points ( n = 1); no dissection extended to the internal iliac or common femoral artery. Conservative treatment was performed in six patients, and the remaining five patients need no treatment. During 23.3 ± 14.2 months follow-up, none recurred symptoms and signs of symptomatic SIIAD; partial remodeling of SIIAD was achieved in four patients, and the remaining seven patients with no change of SIIAD. There was no presence of new false lumen enhancement on contrast-enhanced computed tomography during follow-up. Conclusions SIIAD without arterial rupture or lower limb necrosis can be safely treated with conservative therapy.

Isolated bilateral external iliac artery dissections with emotional stress

“…In patients with asymptomatic isolated iliac artery dissection, conservative treatment was reported to be a safe option. 12 Open surgery can be suitable for patients with a strong desire to continue their sporting lifestyle. 1,9 Endovascular treatment has an advantage over open surgery in that it is less invasive, potentially making it preferable to athletes.…”

“…Conservative treatments, which include close observation, follow‐up imaging, and best medical therapies, can be suitable for patients without symptoms. In patients with asymptomatic isolated iliac artery dissection, conservative treatment was reported to be a safe option 12 . Open surgery can be suitable for patients with a strong desire to continue their sporting lifestyle 1,9 .…”

Spontaneous Isolated Common Iliac Artery Dissection Treated with Self-Expandable Stent in a 38-year-old Patient: A Case Report

“…The study by Liang et al. reported that asymptomatic patients could be safely treated conservatively 12 . However, the question regarding further follow-up is still not answered.…”

“…Endovascular treatment is associated with high technical and clinical success rates with low periprocedural mortality and morbidity when compared with open repair 12 . The implantation of these devices can, in some cases, be limited by tortuosity of the iliac vessels.…”

Management of a Spontaneous Dissection of the Right External Artery

“…The main etiologies include especially collagen vascular disease, pregnancy and intense exercises in athletes [3,4]. Although several treatment options are available, including medical therapy, endovascular or open repair, there is actually no established consensus regarding optimal management of spontaneous iliac artery dissection [5][6][7]. We report the case of a 44 years old patient with no history of vascular diseases or trauma who was admitted in our institution for a spontaneous dissection of the right external iliac artery.…”