title: Morphologic findings and management strategy of spontaneous isolated dissection of the celiac artery.
abstract: OBJECTIVE
  We report the morphologic findings and treatment of spontaneous isolated dissection of the celiac artery (SIDCA).
  
  
  METHODS
  Twenty-three patients with SIDCA presenting between January 2009 and December 2014 were enrolled in this retrospective study. The demographic data, clinical features, morphologic findings, treatment modalities, and follow-up results of these patients were reviewed. We proposed a morphologic classification for SIDCA similar to that of spontaneous isolated dissection of the superior mesenteric artery.
  
  
  RESULTS
  Initially, 11 patients were treated endovascularly, and 12 were treated medically. Four patients treated medically had an aggravation of the dissection and needed endovascular salvage. All patients recovered successfully. None of the patients developed abdominal pain, required reintervention, or died. In the medically treated group, the false lumen was completely thrombosed and absorbed in 4 patients, partially thrombosed in 2, and patent in 2. All stents were patent with the false lumen completely thrombosed and absorbed in the endovascular group.
  
  
  CONCLUSIONS
  SIDCA can be treated medically in stable patients but requires intensive follow-up. Endovascular therapy can be applied in high-risk patients with recurrent symptoms, visceral malperfusion, or aneurysm. Open surgery should be considered if endovascular repair is not suitable or has failed. The short-term results of endovascular management are encouraging but further evaluation with long-term follow-up is necessary.
authors.affiliation: Department of Vascular Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Sun
authors.affiliation: Department of Vascular Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. Electronic address: lidonglin720@hotmail.com.
authors.forename: Dong-Lin
authors.initials: DL
authors.lastname: Li
authors.affiliation: Department of Vascular Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Zi-Heng
authors.initials: ZH
authors.lastname: Wu
authors.affiliation: Department of Vascular Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Yang-Yan
authors.initials: YY
authors.lastname: He
authors.affiliation: Department of Vascular Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Qian-Qian
authors.initials: QQ
authors.lastname: Zhu
authors.affiliation: Department of Vascular Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Hong-Kun
authors.initials: HK
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002445:Celiac Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D000072226:Computed Tomography Angiography / Q000379:methods*; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012039:Regional Blood Flow; D012189:Retrospective Studies; D016879:Salvage Therapy; D015607:Stents; D013997:Time Factors; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome; D014654:Vascular Patency
chemical_list: D002317:Cardiovascular Agents