title: Impact of Noninvasive Conservative Medical Treatment for Symptomatic Isolated Celiac Artery Dissection.
abstract: BACKGROUND
  There is no definite consensus regarding the management of symptomatic isolated celiac artery dissection (ICAD), and the effect of conservative medical treatment has never been evaluated.
  
  
  RESULTS
  We enrolled 13 consecutive symptomatic ICAD patients without signs of arterial rupture between 2006 and 2015. All patients received noninvasive conservative medical treatment. The epidemiology, radiological findings and prognostic effect of conservative medical treatment on outcomes were retrospectively assessed. ICAD usually developed in middle-aged men around 50 years old who had a history of smoking. The patients typically presented with acute continuous epigastric pain at rest and with abdominal tenderness on physical examination. On enhanced computed tomography at presentation, the false lumen was found to be double-barreled in 2 patients (15.4%), partially thrombosed in 1 (7.7%), and completely thrombosed in 10 (76.9%). Dissection of associated branches was found in the left gastric artery in 1 patient (7.7%), common hepatic artery in 5 (38.5%), and splenic artery in 7 patients (53.8%). Malperfusion was not found in the stomach or liver but was found in the spleen in 4 patients (30.8%). During a median follow-up period of 376 (165-602) days, all patients were alive without any antiplatelet, anticoagulant, endovascular or surgical treatment.
  
  
  CONCLUSIONS
  Symptomatic ICAD without arterial rupture can be safely treated with conservative medical therapy over the short term. (Circ J 2016; 80: 1445-1451).
authors.affiliation: Department of Emergency Medicine, Hiroshima City Hospital.
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Ichiba
authors.forename: Masahiko
authors.initials: M
authors.lastname: Hara
authors.forename: Keiji
authors.initials: K
authors.lastname: Yunoki
authors.forename: Masaki
authors.initials: M
authors.lastname: Urashima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Naitou
mesh_terms: D015746:Abdominal Pain; D000784:Aortic Dissection / Q000628:therapy*; D002445:Celiac Artery / Q000473:pathology*; D000072700:Conservative Treatment / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013927:Thrombosis