Single-center experience in the management of spontaneous isolated abdominal aortic dissection

Böckler, Dittmar; Massoni, Claudio Bianchini; Geisbüsch, Philipp; Hakimi, Maani; Von Tengg-Kobligk, Hendrik; Hyhlik-Dürr, Alexander (2016). Single-center experience in the management of spontaneous isolated abdominal aortic dissection. Langenbeck's archives of surgery, 401(2), pp. 249-254. Springer 10.1007/s00423-015-1335-6

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OBJECTIVE This study aims to report the management of patients with spontaneous isolated dissection of the abdominal aorta (sIAAD). METHODS A cohort of 18 consecutive patients (12 male, mean age 58 years) with sIAAD was treated between 1990 and 2009. Dissection was asymptomatic in ten and symptomatic in eight patients. Retrospective data analysis from patient charts was performed. Follow-up included clinical examination, ultrasound, and/or CT-angiography. Mean follow-up was 54 months (range 1-211). RESULTS In total, eight out of 18 received invasive treatment. All asymptomatic patients initially underwent conservative treatment and surveillance. Spontaneous false lumen thrombosis occurred in four (40 %), and three patients showed relevant aneurysmatic progression and underwent elective invasive treatment (open n = 2, endovascular n = 1), representing a crossover rate of 30 %. Late mortality was 20 % (n = 2) in this group. In symptomatic patients, five underwent urgent treatment due to persistent abdominal or back pain (n = 4) or contained rupture (n = 1); one was treated for claudication. The remaining two patients presented with irreversible spinal cord ischemia and were treated conservatively. Three patients were treated by open surgery and three by endovascular interventions (two stentgrafts, one Palmaz XXL stent). Early and late morbidity and mortality was 0 % in this group. There were no reinterventions CONCLUSION: The majority of patients with sIADD require invasive treatment, with EVAR being the preferable treatment option today. In asymptomatic IADD, primary surveillance is justifiable, but close surveillance due to expansion is necessary.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Von Tengg-Kobligk, Hendrik

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1435-2443

Publisher:

Springer

Language:

English

Submitter:

Aisha Stefania Mzinga

Date Deposited:

17 Mar 2016 09:33

Last Modified:

05 Apr 2016 01:31

Publisher DOI:

10.1007/s00423-015-1335-6

PubMed ID:

26395372

Uncontrolled Keywords:

Aneurysm; Aorta; Dissection; Endovascular; Stentgraft; Surveillance

BORIS DOI:

10.7892/boris.77151

URI:

https://boris.unibe.ch/id/eprint/77151

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