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• W4241440562 abstract "This study reports the presentation, treatment, and follow-up of isolated infrarenal aortic dissections. A review of 37 patients with isolated infrarenal aortic dissections was performed. Computed tomography scans with intravenous contrast were examined for all patients, and catheter-based angiograms, magnetic resonance angiograms, and duplex ultrasound were used selectively. In dissections associated with the development of abdominal aortic aneurysm, the aneurysm growth rate was determined by measuring the change in maximum aneurysm diameter over time and dividing that by the duration of observation. The majority of infrarenal abdominal aortic dissection patients were male (67.6%). Hypertension (77.1%) and hyperlipidemia (77.1%) were the most common comorbidities among these patients. Aortic atherosclerosis was also present in 60.0% of patients. A total of 67.6% of dissections were discovered incidentally and were asymptomatic. The mean dissection length was 5.84 ± 4.23 cm. Concomitant abdominal aortic aneurysms were present in 48.6% of cases with an average maximum diameter of 4.38 ± 1.41 cm. The aneurysm growth rate was 1.2 mm/y. Aneurysms were significantly larger in men than in women (4.87 ± 1.31 vs 3.12 ± 0.67 cm; P = .001). Endovascular intervention was performed on 14 patients (37.8%), open surgery was performed on 1 patient (2.7%), and surveillance with conservative medical treatment was used on 22 patients (59.5%). Ten patients were treated successfully with endovascular repair (EVAR) for progressive aneurysm expansion. At the time of intervention, the mean AAA diameter was 5.04 ± 1.39 cm. The mean growth rate for aneurysms that were intervened on was 2.3 mm/y. The mean diameter of AAA that were not intervened on was 3.56 ± 1.04 cm. Type II endoleaks were observed in 3 patients(30%) who underwent EVAR. None of these were associated with aneurysm growth, and none required reintervention. The mortality rate for endovascular intervention was 0%. The only open surgical repair preformed was on a patient with a ruptured abdominal aortic aneurysm, which the patient did not survive. Angioplasty with stent or stent graft placement was performed in 4 patients for the treatment of symptomatic arterial insufficiency resulting from aortic dissection. No patients experienced restenosis and no reinterventions were performed. Isolated infrarenal aortic dissection is an uncommon vascular disease that is related to hypertension, hyperlipidemia, and atherosclerosis, and may be associated with infrarenal abdominal aortic aneurysm formation. The presence of dissection does not appear to increase the risk of complication or mortality for repair of concomitant aneurysm or for treatment of stenosis." @default.
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• W4241440562 date "2016-06-01" @default.
• W4241440562 modified "2023-09-30" @default.
• W4241440562 title "PC048. Contemporary Management of Isolated Chronic Infrarenal Abdominal Aortic Dissections" @default.
• W4241440562 doi "https://doi.org/10.1016/j.jvs.2016.03.284" @default.
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