Morphologic Findings And Management Strategy Of Spontaneous Isolated Dissection Of The Celiac Artery

ObjectiveWe report the morphologic findings and management experience of the spontaneous isolated dissection of the celiac artery (SIDCA) and to explore a therapy strategy for this condition.MethodsTwenty-three patients with SIDCA in our department between January 2009 and December 2014 were enrolled in this retrospective study. The demographic data, clinical features, morphologic findings, treatment modalities and follow-up results were reviewed. We proposed a morphologic classification of SIDCA similar to categorization of spontaneous isolated dissection of the superior mesenteric artery we reported before.Results11 patients received endovascular therapy and 12 patients underwent medical treatment initially.4 patients progressed with dissection aggravations during medical treatment and needed endovascular salvage. All patients recovered smoothly and none had abdominal pain, re-intervention or death. The false lumen was completely thrombosed and absorbed in 4 patients, partially thrombosed in 2 patients and patent in 2 patients in medical group. All stents were patent with the false lumen completely thrombosed and absorbed in the endovascular group.ConclusionSIDCA is a rare vascular disease and medical treatment can be applied in stable patients but needs intensive follow-up. Endovascular therapy can be applied in high-risk patients with recurrent symptoms, visceral malperfusion, or dissecting aneurysms. Open surgery would be considered if endovascular repair is not suitable or has failed. The short-term results of endovascular management are encouraging but further evaluation with long-term follow-up is necessary.