Authors: Honjo, Osami; Sano, Shunji

Source: Vascular Disease Prevention, Volume 3, Number 4, November 2006 , pp. 391-399(9)

Publisher: Bentham Science Publishers

Abstract:

Background: Spontaneous isolated dissection of the iliac artery without involvement of the aorta is extremely rare, and has unique etiological backgrounds. The purpose of this study was to review 34 patients reported in the literature and to discuss etiological and therapeutic considerations.

Methods and Results: Patients (21 male, 13 female) were identified in a PUBMED search since 1966. Median age was 45 years old (rage, 25 to 65 years). The patients were divided into five categories; 1) dissection associated with fibromuscular dysplasia (n=10), 2) associated with Marfan's syndrome or other systemic disorders (n=6), 3) associated with atherosclerosis (n=10), 4) associated with pregnancy (n=2), and 5) associated with exercise (n=6). Four patients went into shock at presentation. Site of dissection was in the common iliac artery in 16 patients, and in the external iliac artery in 18 patients. Bypass surgery was performed in 20 patients, and an endovascular stent was placed in 5 patients. Seven patients had conservative therapy. There were two (6%) hospital deaths. Two patients developed another dissection shortly after treatment. There was no late death related to dissection. One patient had recurrent dissection in the contralateral iliac artery during the median follow-up of 12 months.

Conclusions: Spontaneous isolated dissection of the iliac artery occurred resulting from various etiologies categorizedinto five subgroups. This vascular event is strongly associated with systemic disorders or certain physical conditions asso-ciated with hemodynamic, mechanical and/or hormonal stresses. Despite favorable outcomes, fatal dissection could occur,and awareness of this vascular event, careful follow-up and expeditious diagnosis and management are of great impor-tance to prevent catastrophic consequences.

Keywords: Spontaneous isolated dissection; Iliac artery; arterial dissection

Document Type: Research article

Affiliations: 1: Division of Cardiovascular Surgery, The Hospital for Sick Children, Toronto, 555 University Avenue, Toronto, ON, M5G, 1X8 Canada.

Publication date: 2006-11-01

More about this publication?

• Vascular Disease Prevention publishes reviews as well as original papers to update all those concerned with this topic at the clinical or scientific level. In addition to clinically relevant topics, we consider reviews and original papers dealing with the more scientific aspects of vascular disease prevention. This includes the evaluation of emerging vascular risk factors, research dealing with the pathogenesis of atherosclerosis and the investigation of new treatment options both at the clinical and scientific level (e.g. epidemiology, patient-based studies, experimental models, in vitro experiments or molecular research). Therefore, another function of Vascular Disease Prevention is to bridge the gap between clinical practice and ongoing laboratory-based research.
  
  In particular, we welcome critical reviews and comments on recent trials. This is a topic that requires regular updates because of the large number of trials published every year.
  
  Debates are encouraged in the correspondence section of this journal.
  The editorial structure of Vascular Disease Prevention is set up with the aim of dealing with the submitted material as rapidly as possible. Specialist editors will provide a more expert and rapid assessment unlike a more centralized editorial structure.

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