Spontaneous isolated dissection of the abdominal aorta: single-center experience

Abstract

Isolated abdominal aortic dissection is a rare clinical entity. We report a single-center experience with six patients with acute isolated abdominal aortic dissection managed during a period of seven years. The patients' median age was 62 years and they were predominantly male. All patients presented acutely with abdominal pain, one with hypovolemic shock due to aortic rupture, two with acute lower limb ischemia and one with buttock necrosis. Interestingly, one major symptom was astasia observed in four patients that resolved postoperatively. Computed tomography scan of the thoracic and abdominal aorta was the main diagnostic tool in all patients. Treatment consisted of open repair in three cases and endovascular repair with stent-graft deployment in the remaining three patients. One patient died postoperatively from multiorgan failure. Although natural history and treatment strategies of isolated abdominal aortic dissection have not been well defined, accurate clinical diagnosis and prompt management are essential to prevent adverse complications. Moreover, sudden development of astasia should alert the physician about this pathologic entity.

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).…”

Endovascular treatment for isolated acute abdominal aortic dissection

“…Acute aortic dissection most commonly involves the thoracic aorta and may extend in an antegrade fashion to the abdominal aorta. 1 Unlike dissection of the thoracic aorta, isolated acute dissection of the abdominal aorta (IAAAD) has been considered an unusual event presenting with various clinical signs. 2,3 The natural course of the disease as well as the therapeutic options are not well characterized since data are limited to individual case reports and small patient series.…”

Endovascular Treatment of Isolated Chronic Abdominal Aortic Dissection

“…Due to wall weakening induced by chronic dissection, with higher rupture risk, many surgeons advise earlier intervention in dissecting aneurysms, usually when they reach a diameter of 3 cm. 1,6,7 In result of the scarcity of reported cases, management of IAAD is still a matter of controversy. We describe three cases of chronic IAAD who underwent endovascular treatment.…”

“…Na colagenose perfurante reativa são eliminadas sobretudo fibras de colagénio, na EPS fibras elásticas, enquanto nas foliculites perfurantes o processo de eliminação ocorre através do epitélio do folículo piloso. [1][2][3] A EPS é encontrada predominantemente em adolescentes e adultos jovens, sendo até três vezes mais frequente no sexo masculino.…”