Natural history of spontaneous isolated celiac artery dissection after conservative treatment

Abstract

The clinical course of patients with SICAD was benign. Even progressive vascular changes during follow-up did not require invasive treatment. Antihypertensive therapy might not modify the clinical course. The short-term results of conservative management are encouraging, but further evaluation with long-term follow-up in a large population is needed.

Rare constellation of abdominal vascular injuries in blunt trauma: Left gastric artery pseudoaneurysms and dissection

“…The management of traumatic and spontaneous visceral artery dissections is dependent on patient symptomology and clinical status [[11], [12], [13], [14]]. Advancement in endovascular techniques have led to many surgeons electing to use stenting as an initial approach for patients with persistent abdominal pain, peritoneal signs, aneurysms greater than 2.0 cm, or presence of bowel ischemia [12,13].…”

“…The management of traumatic and spontaneous visceral artery dissections is dependent on patient symptomology and clinical status [[11], [12], [13], [14]]. Advancement in endovascular techniques have led to many surgeons electing to use stenting as an initial approach for patients with persistent abdominal pain, peritoneal signs, aneurysms greater than 2.0 cm, or presence of bowel ischemia [12,13]. Open surgical intervention with vessel over-sew or primary repair continues to be an option for definitive management, but is usually reserved for patients who have failed endovascular management or therapeutic anti-thrombotic therapy, as it carries higher risk of morbidity for patients [11,13].…”

“…Advancement in endovascular techniques have led to many surgeons electing to use stenting as an initial approach for patients with persistent abdominal pain, peritoneal signs, aneurysms greater than 2.0 cm, or presence of bowel ischemia [12,13]. Open surgical intervention with vessel over-sew or primary repair continues to be an option for definitive management, but is usually reserved for patients who have failed endovascular management or therapeutic anti-thrombotic therapy, as it carries higher risk of morbidity for patients [11,13]. Therefore, endovascular and open surgical approaches are recommended in patients who are hemodynamically unstable, have evidence of organ necrosis secondary to dissection, or when vessel rupture is present [13].…”

Role of imaging in visceral vascular emergencies

“…It is primarily treated conservatively with blood pressure control and antithrombotic measures. It is typically seen middle-aged male patients and sudden onset abdominal pain is the main presenting symptom [73].…”

“…CT and MRI may both be used for diagnosis but due to its versatility; contrast-enhanced CT appears to be more pertinent for diagnosis. On CT, dissection flap may be directly seen; however, intramural hematoma with/without associating penetrating ulcer may also be detected [73]. Dissection flap is seen as a linear, thin hypodense structure (Fig.…”