Clinical Characteristics and Prognosis in Spontaneous Isolated Abdominal Aortic Dissection Based on the Dissection...

Area of Science:

• Vascular Surgery
• Cardiovascular Imaging
• Clinical Epidemiology

Background:

• Spontaneous isolated abdominal aortic dissection (SIAAD) is a rare condition.
• Understanding its clinical characteristics and prognosis is crucial for patient management.

Purpose of the Study:

• To classify SIAAD based on dissection length: extensive (e-SIAAD) and focal (f-SIAAD).
• To compare clinical features, imaging findings, and long-term outcomes between e-SIAAD and f-SIAAD.

Main Methods:

• Retrospective study of 159 SIAAD patients from March 2012 to September 2023.
• Morphologic classification based on dissection length (>50 mm for e-SIAAD, ≤50 mm for f-SIAAD).
• Comparison of clinical data, computed tomography angiography (CTA) findings, and follow-up outcomes.

Main Results:

• Focal SIAAD patients were older, with more atherosclerosis and penetrating aortic ulcers.
• Extensive SIAAD presented more acutely, with larger diameters and greater arterial involvement.
• In-hospital and long-term mortality were higher in focal SIAAD.

Conclusions:

• SIAAD classification by length significantly impacts clinical presentation and prognosis.
• Focal dissections are associated with older age, severe arteriosclerosis, and poorer outcomes.
• Tailored management approaches are necessary for different SIAAD classifications.