Endovascular treatment for isolated acute abdominal aortic dissection

Abstract

Based on our series, IAAAD may represent a not so rare clinical entity as generally thought, suggesting that it may be underdiagnosed. Endovascular treatment of IAAAD appears to be a feasible and efficient therapeutic approach and might be considered as the first-line treatment in all patients with suitable anatomy.

Treatment strategy based on the natural course of the disease for patients with spontaneous isolated abdominal aortic dissection

“…In our literature review, 2,6,8,10,[15][16][17][18][19][20][21][22][23][24][25][26] symptomatic patients numbered 68%, and AAA or CTD coexisted in 47% and 6.4% of patients, respectively. Aortic rupture developed in 6.9% of the patients, and the iliac or visceral artery was involved in 48.4% and 11%, respectively (Table VI).…”

“…However, there have been various suggestions for management of noncomplicated, asymptomatic SIAAD ranging from early prophylactic interventions to conservative management. 6,7 Advocates for early prophylactic interventions are concerned about the risk of aortic rupture, visceral ischemia, or leg ischemia in SIAAD patients. [8][9][10] There is not sufficient evidence to support either early prophylactic intervention or conservative treatment for patients with noncomplicated SIAAD.…”

Endovascular treatment of isolated abdominal aortic dissection and postoperative aortic remodeling

“…Medically managed IAADs usually progress with a high mortality rate; therefore, aggressive surgical or endovascular treatment has been recommended. 4,5 Although endovascular treatment of infrarenal IAAD has recently been reported as an efficient therapeutic approach, 6,7 whether endovascular treatment of suprarenal IAAD is safe with a durable result is unknown. Successful endovascular treatment of aortic dissection could promote aortic remodeling, but little has been reported about aortic remodeling after endovascular intervention in IAADs.…”

Endovascular treatment of spontaneous isolated abdominal aortic dissection

“…During the follow-up period, all patients remained symptom-free and the dissection length remained stable (7). Endovascular or surgical interventions are suggested in all patients with dissection and concomitant aortic aneurysm (aortic diameter exceeding 3 cm), or in patients with signs of aortic rupture, ischemic symptoms, and unremitting pain in a non-dilated aorta (5,6,8). The patients who referred to our institute were affected by symptomatic isolated abdominal dissection in absence of thoracic aortic involvement and aneurysmatic dilatation of the abdominal aorta.…”