TY - JOUR
T1 - The management of localized abdominal aortic dissections
AU - Graham, Debra
AU - Alexander, J. Jeffrey
AU - Franceschi, Dido
AU - Rashad, mid Fouad
N1 - Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 1988/11
Y1 - 1988/11
N2 - Aortic dissections limited to the abdominal aorta occur infrequently. We have identified four cases of abdominal aortic dissection and have reviewed these in combination with 43 previously reported cases to identify factors that influence the prognosis and management of this disease. Abdominal aortic dissections are similar to thoracic dissections in their presentation, with acute shearing pain and systolic hypertension occurring commonly. Although the diagnosis may be made by ultrasonography or CT scanning, angiography is the definitive diagnostic study. Factors found to be associated with high mortality include presentation with acute pain (p < 0.0003), involvement of visceral vessels (p < 0.02), and rupture (p < 0.000002). Chronicity appears to be protective (p < 0.04), although chronic dissections may present acutely. Although prosthetic replacement of the involved aorta is the treatment of choice in most cases, nonoperative management with regular follow-up can be considered in asymptomatic chronic dissections.
AB - Aortic dissections limited to the abdominal aorta occur infrequently. We have identified four cases of abdominal aortic dissection and have reviewed these in combination with 43 previously reported cases to identify factors that influence the prognosis and management of this disease. Abdominal aortic dissections are similar to thoracic dissections in their presentation, with acute shearing pain and systolic hypertension occurring commonly. Although the diagnosis may be made by ultrasonography or CT scanning, angiography is the definitive diagnostic study. Factors found to be associated with high mortality include presentation with acute pain (p < 0.0003), involvement of visceral vessels (p < 0.02), and rupture (p < 0.000002). Chronicity appears to be protective (p < 0.04), although chronic dissections may present acutely. Although prosthetic replacement of the involved aorta is the treatment of choice in most cases, nonoperative management with regular follow-up can be considered in asymptomatic chronic dissections.
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U2 - 10.1016/0741-5214(88)90309-6
DO - 10.1016/0741-5214(88)90309-6
M3 - Article
C2 - 3054172
AN - SCOPUS:0024246920
VL - 8
SP - 582
EP - 591
JO - Journal of Vascular Surgery
JF - Journal of Vascular Surgery
SN - 0741-5214
IS - 5
ER -