Objective: To explore the diagnosis and treatment of spontaneous isolated middle aortic dissection (SIMAD).
Methods: The clinical data of 7 SIMAD patients admitted into our hospital between January 2007 and June 2011 were retrospectively analyzed.
Results: There were 3 males and 4 females with an average age of 53 years old. Five patients had an acute onset. According to the original tear location and flow of celiac artery, 6 patients received endovascular repair and another patient underwent abdominal aorta-bilateral-femoral artery bypass with artificial graft. All cases were successfully treated. Six patients recovered well from the procedures. One patient suffered acute coronary artery syndrome at Day 2 after endovascular treatment. After transferral into cardiology unit, emergency percutaneous transluminal coronary angioplasty was performed with a satisfactory outcome. The postoperative examinations of CTA (computed tomography angiography) of all patients demonstrated that the false lumen of dissection was basically thrombolized without endoleak or stent migration.
Conclusion: Vascular surgeons should pay more attention to SIMAD with the potentials of rupture and aneurysm. Endovascular graft exclusion may be a first-line therapy as long as the anatomical conditions allow. However, longer follow-up and further evaluations should be performed to determine the long-term benefits.