[MO-82] Presentation Awards
Treatment of Infrarenal abdominal aortic dissections with the Endologix AFX-2 Unibody Endograft: A case series
Introduction
Spontaneous, isolated infrarenal aortic dissections are a rare, clinical entity that can be often fatal if a prompt diagnosis is not made. Infrarenal aortic dissections make up less than 1% of all aortic dissections and can present in a myriad of ways. The etiology of such dissections is usually trauma, iatrogenic or spontaneous. We report the experience of our institution in the diagnosis and management of spontaneous IAAD. Special emphasis is given on the clinical presentation of this rare entity and the treatment options that can be applied to in order to avoid adverse complications.
Methods
We reviewed the published literature relevant to clinical presentation and management of isolated infrarenal aortic dissections.
Results
In our institution we report a total of three patients who presented with infrarenal aortic dissections. Two patients presented with erectile dysfunction as their primary presentation, and the third presented with abdominal pain radiating to the back following trauma. All patients were treated endovascularly using the AFX®2 Bifurcated Endograft (Endologix, USA). Proximal fixation in all patients was infrarenal and in two patients there was unilateral iliac graft extension. There was no associated morbidity or mortality at thirty-days or twelve-months. Follow-up imaging at six months demonstrated total exclusion of the aortic dissection. The two patients who experienced erectile dysfunction had complete resolution of symptoms.
Conclusion
Infrarenal aortic dissection is a rare clinical condition that may have several of clinical presentations with potential serious adverse effects. Typically presenting with an acute onset of abdominal pain radiating to the back and the buttocks signs of limb ischemia, it should be considered as a potential differential diagnosis for males new-onset erectile dysfunction. Although the natural history of this process is not yet clearly described, early diagnosis and prompt initiation of treatment are key components in avoiding lethal complications.
Spontaneous, isolated infrarenal aortic dissections are a rare, clinical entity that can be often fatal if a prompt diagnosis is not made. Infrarenal aortic dissections make up less than 1% of all aortic dissections and can present in a myriad of ways. The etiology of such dissections is usually trauma, iatrogenic or spontaneous. We report the experience of our institution in the diagnosis and management of spontaneous IAAD. Special emphasis is given on the clinical presentation of this rare entity and the treatment options that can be applied to in order to avoid adverse complications.
Methods
We reviewed the published literature relevant to clinical presentation and management of isolated infrarenal aortic dissections.
Results
In our institution we report a total of three patients who presented with infrarenal aortic dissections. Two patients presented with erectile dysfunction as their primary presentation, and the third presented with abdominal pain radiating to the back following trauma. All patients were treated endovascularly using the AFX®2 Bifurcated Endograft (Endologix, USA). Proximal fixation in all patients was infrarenal and in two patients there was unilateral iliac graft extension. There was no associated morbidity or mortality at thirty-days or twelve-months. Follow-up imaging at six months demonstrated total exclusion of the aortic dissection. The two patients who experienced erectile dysfunction had complete resolution of symptoms.
Conclusion
Infrarenal aortic dissection is a rare clinical condition that may have several of clinical presentations with potential serious adverse effects. Typically presenting with an acute onset of abdominal pain radiating to the back and the buttocks signs of limb ischemia, it should be considered as a potential differential diagnosis for males new-onset erectile dysfunction. Although the natural history of this process is not yet clearly described, early diagnosis and prompt initiation of treatment are key components in avoiding lethal complications.