No deaths were reported among patients who underwent surgery or had an endovascular procedure, irrespective of their preoperative status. The patient who died was medically managed. The overall in-hospital mortality rate was 5.6% (n = 1). The 18 IAAAD patients were medically, surgically, or percutaneously managed in 12 (66.6%), five (27.8%), and one (5.6%) cases, respectively. No neurologic symptoms, such as ischemic spinal cord damage or ischemic peripheral neuropathy, occurred in the IAAAD cohort. IAAAD was iatrogenic in 2 cases (11%).Ĭompared with patients with type B aortic dissections, abdominal pain, mesenteric ischemia or infarction, limb ischemia, and hypotension as initial clinical signs were significantly more frequent in patients with IAAAD, whereas chest pain was more typical in patients with type B dissections. Aortic aneurysms pre-existed in 5 patients (28%). Theor mean age was 67.7 +/- 13.3 years, with a male predominance (n = 12, 67%). Among 1417 patients enrolled in the IRAD from 1996 to 2003, 532 (37.5%) had an acute type B dissection, of which 18 (1.3%) had an IAAAD. The aim of this study was to identify clinical characteristics, therapeutic approaches, risk factors for mortality, in-hospital outcome, and long-term results of this cohort, thus clarifying its natural history.Ī comprehensive analysis of 290 clinical variables on 18 patients affected by isolated acute abdominal aortic dissection (IAAAD) was performed. We report data from the International Registry of Acute Aortic Dissection (IRAD), the largest group of patients treated for acute aortic dissections. Because its incidence is low, the natural history is unknown. Isolated acute dissection of the abdominal aorta is an unusual event that may present with several different clinical scenarios.

Irad aortic dissection