Endovascular Repair of Isolated Abdominal Aortic Dissection. Literature Review

Two operative cases of abdominal aortic aneurysm with isolated dissection of the abdominal aorta

“…IAAD is rare disease entity accounting for 1–4% of all aortic dissections 1 ) . Studies have shown that in more than half of the cases, IAAD leads to AAA development 1 , 2 ) . Some review articles strongly suggested that IAAD is a complication of penetrating atherosclerotic ulcers (PAUs) 3 , 4 ) .…”

“…Most reports describe that the initial symptom is pain. Persistent pain indicates that dissection of the aortic wall is progressing and that immediate therapeutic intervention is necessary 2 , 6 ) , as in type B aortic dissection with or without AAA. When IAAD involves an AAA but the pain is under control, the shape and diameter of the AAA are important considerations.…”

“…Although it is still controversial, a previous study strongly suggested that saccular aneurysms require immediate surgery regardless of the size 6 ) . Conversely, a recent review article 2 ) suggested that intervention should be considered when the diameter exceeds 30 mm because the minimum reported diameter of ruptured AAAs with IAAD is 35 mm 7 ) . Unfortunately, the number of cases reported in studies to date is insufficient to definitively determine the surgical indication of AAA with IAAD.…”

The Spectrum of the Diseased Aortic Wall. Dissection and other Acute Aortic Syndromes...

“…An interesting review concerning this entity is reported in the next pages of this journal [1]; in an extended search of the world literature, the authors found that the AAD is observed more often in men than women (3:1), is acute in 72%, spontaneous in 87.5%, traumatic in 6.25% and iatrogenic in a good 6.25% of the patients; in 57.2% of the cases the entry point was located distal to the origin of renal arteries.…”

“…In this issue, Dodos et al review thoroughly the reported strategy for managing specifically patients with AAD [1]. Dissected aortas represent the utmost scenario of arterial wall disaster; medicine along with science and technology have, on the one hand to offer a biological solution for the remodelling of the diseased aortic wall, and on the other hand to support the spinal cord supply in extended dissections where the risk of paraplegia, although recently minimized, it cannot be eliminated despite the application of all modern adjuncts.…”