Malan,” University of Milan, via Morandi 30, 20097 San Donato Milanese, Italy. Hematuria associated with dissecting aneurysms of the abdominal aorta. Aortic dissection presenting as iliac artery occlusion. The mean age of all patients at the time of diagnosis was 58.6 years (range 27 to 75 years). Specific signs of aortic dissection include visualization of a double channel, the presence of a linear radiolucency within the aortic lumen, demonstration of entry or reentry tears, and branch involvement. https://doi.org/10.1016/j.acvfr.2012.04.003. Aortic dissection (AD) occurs when an injury to the innermost layer of the aorta allows blood to flow between the layers of the aortic wall, forcing the layers apart. The patient who died was medically managed. Survival in this group was not significantly altered by operation. A 65-year-old normotensive white man was admitted to the hospital for evaluation of amaurosis fugax. Aortic dissections limited to the abdominal aorta occur infrequently. No deaths were reported among patients who underwent surgery or had an endovascular procedure, irrespective of their preoperative status. Dissections and aneurism. Comme la patiente restait symptomatique en dépit d’un traitement médical optimal, on a proposé une revascularisation chirurgicale. Long-term survival in patients with type B aortic dissection: insights from the International Registry of Acute Aortic Dissection (IRAD). Similar to that for descending thoracic aortic dissection. Real time ultrasound in the diagnosis of acute dissecting aneurysm of the abdominal aorta. The abdominal aorta was replaced in five patients, and one patient also had a surgical peripheral vessel management. On the basis of the present natural history report, continued surveillance appears mandatory. IAAAD was identified using one diagnostic examination in 16.7% (n = 3) of patients or two or more in 83.3% (n = 15). Peu de cas de dissection aortique avec TA ont été publiés, qui sont commentés dans cet article. Data are shown as frequencies and percentages, and mean ± standard deviation or as a median (interquartile range). Diagnosis and management of aortic dissection. Aortographic analysis of aortic dissection. Compared with patients with type B aortic dissections, abdominal pain, mesenteric ischemia or infarction, limb ischemia, and hypotension as initial clinical signs were significantly more frequent in patients with IAAAD, whereas chest pain was more typical in patients with type B dissections. Surgical management of dissecting aneurysms of the aorta. 2). The 18 IAAAD patients were medically, surgically, or percutaneously managed in 12 (66.6%), five (27.8%), and one (5.6%) cases, respectively. Intramural aortic dissection as a complication of translumbar aortography. The Stanford classification divides dissections by the most proximal involvement: type A: A affects ascending aorta accounts for ~60% of aortic dissections In two cases, acute renal failure was attributed to renal hypoperfusion during shock. Dublin Hosp Rep 1822;3:231-40. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. We report data from the International Registry of Acute Aortic Dissection (IRAD), the largest group of patients treated for acute aortic dissections. Acute traumatic dissecting aneurysm of the abdominal aorta. Une femme de 24 ans a développé une dissection chronique douloureuse de l’aorte sous-rénale avec une claudication des deux membres inférieurs. Spontaneous dissecting hematoma (aneurysm) of the abdominal aorta in the Leriche syndrome. In most cases, this is associated with a sudden onset of severe chest or back pain, often described as "tearing" in character. B-mode ultrasonography has been used to demonstrate an echogenic, intimal flap, but this finding can be easily missed in a nondilated aorta. Race was indicated in only 20 cases; most of these patients were white (75%). The mean survival rate was 93% ± 13% at 1 year and 73% ± 27% at 5 years. Because its incidence is low, the natural history is unknown. For this analysis, 18 patients with isolated acute aortic dissection confined to the subdiaphragmatic aortic level were analyzed. Traumatic dissecting aneurysm of the abdominal aorta. None of the patients in the IAAAD cohort had Marfan syndrome. Renal insufficiency, varying from a transient azotemia to progressive renal failure, occurred in seven patients, five of whom died. Role and results of surgery in acute type B aortic dissection - insights from the International Registry of Acute Aortic Dissection (IRAD). 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. Twelve major perioperative complications occurred in 10 patients. He was readmitted one year later with recurrent chest pain. *Reprint requests: J. Jeffrey Alexander, MD, Dept. The overall in-hospital mortality rate was 5.6% (n = 1). Her medical history included mitral valve commissurotomy 12 years earlier, which was complicated by a right hemispheric stroke. In search for optimal treatment of complicated acute type B aortic dissection: insights from the International Registry of Acute Aortic Dissection (IRAD). Peu de cas de dissection aortique avec TA ont été publiés, qui sont commentés dans cet article. IAAAD is a condition that may present differently compared with classic type B aortic dissections. An extensive search of the literature yielded an additional 43 cases. Cited in Peacock TB. Medical histories were often incompletely reported. Abdominal ultrasonography (Fig. Isolated acute dissection of the abdominal aorta is an unusual event that may present with several different clinical scenarios. In this series, the diagnosis was made by angiography in 17 cases (36%) and ultrasonography in one case (2%). 4) showed a posterior-lateral dissection of the abdominal aorta from the celiac axis to the iliac arteries, with apparent reentry at the level of the aortic bifurcation. We were also unable to evaluate other end points such as freedom from reoperation, rupture, or redissection. There are few reports of this in the literature after open aneurysmectomy,1, 2 and to our knowledge, only one report after endovascular AAA repair (EVAR). In most cases (70%), symptoms were of acute onset. Overall survival was 93.3% ± 12.6% at 1 year and 73.3% ± 27.2% at 5 years. Acute dissection originating in the abdominal aorta. Un pontage aortobifémoral a été fait avec résection de l’aorte sous-rénale et le diagnostic histologique de TA. Aspects cliniques de la médionecrose aortique à propos de 15 observations. The remaining 21 patients were managed surgically. No deaths were reported among patients who underwent a surgical or endovascular procedure, irrespective of their preoperative status. Presenting signs and symptoms may be nonspecific. Aortic aneurysms pre-existed in 5 patients (28%). IAAAD is a rare condition that presents with significant clinical variability. Data were analyzed by means of the Fisher exact test. Acute dissection confined to the abdominal aorta. Although not supported because of the small sample size, we suggest that an endovascular approach should be considered primarily in the presence of comorbidities such as a history of ischemic cardiac diseases. A comprehensive analysis of 290 clinical variables on 18 patients affected by isolated acute abdominal aortic dissection (IAAAD) was performed.