title: Spontaneous dissection of the infrarenal abdominal aorta.
abstract: Spontaneous infrarenal abdominal aortic dissection is rare. We observed enlargement of a spontaneous infrarenal aortoiliac dissection in a 55-year-old hypertensive man. Open surgical repair with a bifurcated polyester graft was successful. A review of the English literature found 41 previously published cases. Mean age was 58 years, 74% of the patients were male, and 62% had hypertension. None had Marfan or Ehlers-Danlos syndrome. More than three fourths of the patients had symptoms, 6 patients (14%) presented with aortic rupture. Dissection was limited to the infrarenal aorta in 50% and extended into the iliac or femoral arteries in 50%. Three patients died before treatment, no death occurred after endovascular repair of after elective open aortic grafting. Mortality following rupture was 67%. Abdominal aortic dissection did not reoccur but 1 patient died at 14 month because of rupture of a thoracic aneurysm. Spontaneous infrarenal abdominal aortic dissections are rare, but usually symptomatic and 14% rupture. Rupture carries high mortality. Elective open repair is recommended, but endovascular repair is a new treatment option for suitable patients.
authors.affiliation: Division of Vascular Surgery, Department of Internal Medicine and Radiology, Mayo Clinic and Foundation, Rochester, MN 55905, USA.
authors.forename: Géza
authors.initials: G
authors.lastname: Mózes
authors.forename: Peter
authors.initials: P
authors.lastname: Gloviczki
authors.forename: Woosup M
authors.initials: WM
authors.lastname: Park
authors.forename: Henry L
authors.initials: HL
authors.lastname: Schultz
authors.forename: James C
authors.initials: JC
authors.lastname: Andrews
mesh_terms: D000784:Aortic Dissection / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color