Effectiveness of the Conservative Therapy for Symptomatic Isolated Celiac Artery Dissection

To investigate the effectiveness of the conservative therapy for symptomatic isolated celiac artery dissection (ICAD).

Patients with symptomatic ICAD diagnosed on CT between February 2006 and June 2016 at three institutions were included.

During the study period, a total of 24 patients (22 men, 2 women) were included in this retrospective study. Patients most commonly presented with epigastric pain (n = 21) or back pain (n = 3). Initial CT findings included celiac arterial calcification (n = 3); compression of the true lumen (n = 24), including stenosis of the true lumen <50% (n = 14) or ≥50% (n = 10); completely thrombosed (n = 11) or partially thrombosed (n = 5) false lumen; no thrombosis of the false lumen but presence of dissecting aneurysm (n = 8); and dissection extending to the common hepatic (n = 1) or splenic (n = 6) artery. Twenty-three patients recovered after conservative treatment, and one patient who failed conservative treatment recovered after surgical therapy. Of the 23 patients who received conservative treatment, complete or partial remodeling of ICAD was achieved in 18 (78.3%) and 5 (21.7%) patients during 22.1 ± 13.3 months of follow-up.

Conservative treatment can be applied successfully in most patients with symptomatic ICAD. Most cases of symptomatic ICAD resolve spontaneously within 2 years.