The management of localized abdominal aortic dissections

Debra Graham, J. Jeffrey Alexander, Dido Franceschi, mid Fouad Rashad

Research output: Contribution to journalArticle

48 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)582-591
Number of pages10
JournalJournal of vascular surgery
Volume8
Issue number5
DOIs
StatePublished - Nov 1988
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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