Dissection of the Celiac Trunk Is a Mild Disease

Philippe Tresson; Maria Tawdi; Emeraude Rivoire; Antoine Millon; Guillaume Passot; Olivier Rouvière; Anne Long

doi:10.1016/j.avsg.2024.01.014

Dissection of the Celiac Trunk Is a Mild Disease

Ann Vasc Surg. 2024 Apr 5:105:362-372. doi: 10.1016/j.avsg.2024.01.014. Online ahead of print.

Authors

Philippe Tresson¹, Maria Tawdi², Emeraude Rivoire³, Antoine Millon⁴, Guillaume Passot⁵, Olivier Rouvière⁶, Anne Long³

Affiliations

¹ Hospices Civils de Lyon, Hôpital Louis Pradel, Service de Chirurgie Vasculaire et Endovasculaire, Bron cedex, France. Electronic address: philippe.tresson@chu-lyon.fr.
² Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Médecine Interne et de Médecine Vasculaire, Lyon cedex, France.
³ Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Médecine Interne et de Médecine Vasculaire, Lyon cedex, France; Université Claude Bernard Lyon 1, LIBM EA7424, Equipe Athérosclérose, Thrombose et Activité Physique, Faculté de Médecine Rockefeller, Lyon, France.
⁴ Hospices Civils de Lyon, Hôpital Louis Pradel, Service de Chirurgie Vasculaire et Endovasculaire, Bron cedex, France; Université Claude Bernard Lyon 1, LIBM EA7424, Equipe Athérosclérose, Thrombose et Activité Physique, Faculté de Médecine Rockefeller, Lyon, France.
⁵ Hospices Civils de Lyon, Hôpital Lyon Sud, Service de Chirurgie Digestive, Lyon cedex, France.
⁶ Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Radiologie Urinaire et Vasculaire, Lyon cedex, France.

PMID: 38583764
DOI: 10.1016/j.avsg.2024.01.014

Abstract

Background: The purpose of this study was to assess whether the presence of an aneurysmal or dissecting arterial disease was a risk factor of poor prognosis in patients presenting a dissection of the celiac trunk (CT).

Methods: All patients presenting a CT dissection between January 1, 2014, and June 30, 2022, were included. Patients with a CT dissection due to the extension of an aortic dissection were excluded. Les antécédents familiaux de dissection, de maladie anévrysmale, de maladie athéromateuse ou du tissu conjonctif, la pratique d'une activité physique ou sportive, un effort inhabituel les jours précédant la dissection ainsi qu'un traumatisme étaient recherchés. Family history of dissection, aneurysmal disease, atheromatous or connective tissue disease, physical activity or sport, an unusual effort in the days prior to the dissection and trauma were sought after. Ischemic or aneurysmal complications in the acute phase and the evolution of the dissection were evaluated and compared between patients with an isolated dissection and those presenting an aneurysmal or dissecting arterial disease.

Results: 45 patients were included in the study. Twenty-three (51.1%) patients presented with symptomatic CT dissection, and 22 (48.9%) with asymptomatic CT dissection. All the patients initially had medical management alone. The mean follow-up was 32 ± 25 months and all patients were asymptomatic at the time last news. 24 (53.3%) presented an isolated CT dissection, and 21 (46.7%) a CT dissection associated with aneurysmal or dissecting arterial disease. There was no significant difference between patients with an isolated CT dissection and those with an associated dissecting or aneurysmal pathology.

Conclusions: CT dissection is a stable disease in the midterm, which makes it a mild arterial pathology, with or without aneurysmal or dissecting anomalies in another territory. The mechanical stress exerted on the CT by the arcuate ligament could be responsible for parietal trauma and favor the occurrence of a CT dissection.