Abstract
Purpose
Review of the indications for, and the post-operative complications and mortality rates of endovascular techniques for treating abdominal aortic dissection (AAD).
Methods
An electronic health database search was performed using PubMed, Medline and EMBASE for publications on AAD. The search yielded multiple case reports, which were not included here, and 9 recent series with sufficient data for analysis.
Results
The series included in the review reported data on a total of 208 patients. Of the AADs recorded, 182 were spontaneous (87.5%), 13 traumatic (6.25%) and 13 iatrogenic (6.25%), and the majority were of acute presentation (150 patients, 72%). The mean age of the patients was 62.6 years. Hypertension was the most prevalent risk factor (133 patients, 64%). Concurrent aortic aneurysms were more often associated with spontaneous dissection (56 patients, 27%). Open surgical repair was performed in 54 patients (26%), endovascular repair in 94 (45%) and the treatment was conservative in 60 (29%). The in-hospital mortality was 2% for the endovascular group, 5% for the open repair group and ~7% for those receiving conservative treatment. More complications were reported in the patients treated by open surgery than in those undergoing endovascular repair.
Conclusions
Patients with AAD are at considerable risk of complications and in-hospital mortality. Based on current evidence, endovascular treatment appears to be associated with a lower risk of major complications and mortality than open repair or conservative treatment, and the need for secondary intervention is rare.
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Dodos, I.A., Theodoridis, P., Staramos, D. et al. Endovascular Repair of Isolated Abdominal Aortic Dissection. Literature Review. Hellenic J Surg 90, 85–89 (2018). https://doi.org/10.1007/s13126-018-0445-3
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DOI: https://doi.org/10.1007/s13126-018-0445-3