Isolated Abdominal Aortic Dissection With and Without Abdominal Aortic Aneurysm.

Area of Science:

• Vascular Surgery
• Cardiovascular Research
• Aortic Disease

Background:

• Isolated aortic dissection of the abdominal aorta (IAAD) is an uncommon condition.
• IAAD can occur independently or concurrently with abdominal aortic aneurysms (AAA).

Purpose of the Study:

• To describe the clinical presentation and treatment outcomes of IAAD patients.
• To analyze outcomes of IAAD with and without concomitant AAA.

Main Methods:

• Retrospective review of 18 IAAD patients (2002-2023) from a South American academic hospital.
• Analysis of treatment strategies including conservative management, endovascular, and open surgery.
• Evaluation of outcomes, complications, and aortic remodeling.

Main Results:

• 10 patients (55.5%) had concomitant AAA (median size 49.5 mm).
• Acute dissection was more common (61.1%). Treatments included conservative (27.7%), endovascular (44.4%), and open surgery (27.7%).
• Complication rate was 22.2%, with 0% mortality. Complete aortic remodeling occurred in most patients.

Conclusions:

• IAAD is rare but manageable with diverse treatment options.
• Concomitant AAA may favor invasive treatment for IAAD.
• Further research on AAA natural history, IAAD association, and long-term remodeling outcomes is needed.