This decision is greatly influenced by anatomical conditions along with the surgeon’s experience. Therapeutic strategies are conservative in the asymptomatic form with a non-dilated aorta, while open or endovascular repair are the treatment of choice in the symptomatic cases. The most common symptom is abdominal or back pain, while claudication and lower limb ischemia are rare ( 1, 2). Natural history and therapeutic options of IAAD are not well known its low incidence in the literature is based mainly on case reports and few case series. The clinical presentation of the disease may be acute, with an abrupt onset of symptoms, or chronic presenting ≥14 days of symptom onset. Co-existing abdominal aortic aneurysm and penetrating aortic ulcers are frequently associated. Most patients with this pathology are male, with a median age of 60 years, and usually with concomitant high blood pressure ( 1). The causes of IAAD may be spontaneous, traumatic, or iatrogenic. Isolated abdominal aortic dissection (IAAD) is rare, usually limited to the infrarenal aorta. Endovascular management of this condition is associated with a high rate of technical success and a low mortality therefore, it can be considered the treatment of choice when it is feasible. All patients completed a CTA follow-up of at least 12 months, during which they remained symptom-free. In four symptomatic cases, non-responsive to medical therapy, bare-metal stents or stent grafts were successfully positioned. All nine patients initially underwent medical treatment. Diagnosis of isolated abdominal aortic dissection were established by contrast-enhanced computed tomography angiography (CTA) of the thoracic and abdominal aorta. All patients were men, smokers, symptomatic (either abdominal or back pain or lower limb ischemia), with a history of high blood pressure, with a medical history negative for concomitant aneurysmatic dilatation or previous endovascular intervention. We herein describe nine cases of symptomatic spontaneous isolated abdominal aortic dissection, out of which four successfully were treated with an endovascular approach between July 2003 and July 2013. Surgical and endovascular treatment are two valid options with acceptable results. Most patients are asymptomatic and symptoms are usually abdominal or back pain, while claudication and lower limb ischemia are rare. The causes of this pathology can be spontaneous, iatrogenic, or traumatic. ![]() There are a few case series reported in the literature. Isolated abdominal aortic dissection is a rare clinical disease representing only 1.3% of all dissections.
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