Spontaneous external iliac artery dissection treated conservatively: A case report and review of the management...

Spontaneous iliac artery dissection (IAD) is a rare condition that is usually associated with connective tissue diseases. Complications include ischemia due to malperfusion and bleeding due to rupture. Treatments vary depending on the expertise and presenting symptoms; they include conservative, endovascular, and surgical options.

Here, we present the case of a 45-year-old man who presented with right lower quadrant pain and hypertension as well as normal laboratory results. A contrast-enhanced computed tomography (CT) scan of the abdomen revealed an isolated dissection of the right external iliac artery. The patient had intact distal pulses and no other abnormal findings. He was admitted to the intensive care unit to control his high blood pressure with antihypertensive medications. The patient recovered well and was discharged home in stable condition with antiplatelet and antihypertensive therapy. The follow-up with the patient continued for one year.

Given the rarity of this disease, the treatment protocols and outcomes are still a matter of ongoing debate. Complicated cases with rupture should be treated on an emergency basis using open and endovascular repairs. In asymptomatic and symptomatic patients without rupture, medical treatment and possibly endovascular treatments are considered.

Conservative management of uncomplicated asymptomatic IAD should be considered as first-line therapy.