title: Clinical Features and Therapeutic Options for Isolated Visceral Artery Dissection.
abstract: BACKGROUND
  The diagnosis of isolated visceral artery dissection (IVAD) has become more common with the increasing use of computed tomography angiography (CTA). We examined the presentation, treatment, and outcomes of patients with IVAD treated at our institution.
  
  
  METHODS
  The records of 72 patients treated for IVAD between January 2010 and August 2014 were analyzed retrospectively. All were treated with antiplatelet or anticoagulant drugs after admission and were continued on oral aspirin for at least 1 year. Four asymptomatic and 52 symptomatic patients were managed conservatively with blood pressure control, bowel rest, fluid supplementation, and nutritional support. Two patients underwent open surgery because of hematochezia and 16 underwent endovascular bare-metal stenting.
  
  
  RESULTS
  Symptoms gradually resolved in those treated conservatively, and favorable arterial wall remodeling was observed in 16 patients. Twenty-one stents were implanted in 16 patients with superior mesenteric artery dissection; 3 patients required overlapping stents. During follow-up (range, 3-53 months), all patients were symptom-free, and there were no recurrences. Follow-up CTA of patients who underwent endovascular stenting demonstrated satisfactory stent and true lumen patency.
  
  
  CONCLUSIONS
  IVAD is not uncommon. It occurs most frequently between the ages of 46 and 60 years and affects more men than women. A favorable outcome can be achieved in most of the patients with conservative management. Ischemic bowel necrosis is rare but requires open surgery. Endovascular bare-metal stenting is recommended when there is persistent abdominal pain, progression of the lesion, apparent stenosis of a true lumen compressed by a false lumen, or dilation of false lumen at a high risk of rupture.
authors.affiliation: Department of Vascular Surgery, Second Hospital Affiliated to Soochow University, Soochow, China; Department of Vascular Surgery, The Clinical Medical College of Yangzhou University, Yangzhou, China.
authors.forename: Zhao-Lei
authors.initials: ZL
authors.lastname: Chen
authors.affiliation: Department of Vascular Surgery, The Clinical Medical College of Yangzhou University, Yangzhou, China.
authors.forename: Xi-Cheng
authors.initials: XC
authors.lastname: Zhang
authors.affiliation: Department of Vascular Surgery, The Clinical Medical College of Yangzhou University, Yangzhou, China.
authors.forename: Guang-Rui
authors.initials: GR
authors.lastname: Pan
authors.affiliation: Department of Vascular Surgery, The Clinical Medical College of Yangzhou University, Yangzhou, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Vascular Surgery, The Clinical Medical College of Yangzhou University, Yangzhou, China.
authors.forename: Miao
authors.initials: M
authors.lastname: Xu
authors.affiliation: Department of Vascular Surgery, Second Hospital Affiliated to Soochow University, Soochow, China. Electronic address: flytsg@126.com.
authors.forename: Xiao-Qiang
authors.initials: XQ
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D000925:Anticoagulants / Q000627:therapeutic use; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014781:Viscera / Q000098:blood supply*
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors