PDF(Pubmed)
Abstract：
UNASSIGNED: Spontaneous iliac artery dissection (IAD) is a rare condition that is usually associated with connective tissue diseases. Complications include ischemia due to malperfusion and bleeding due to rupture. Treatments vary depending on the expertise and presenting symptoms; they include conservative, endovascular, and surgical options.
METHODS: Here, we present the case of a 45-year-old man who presented with right lower quadrant pain and hypertension as well as normal laboratory results. A contrast-enhanced computed tomography (CT) scan of the abdomen revealed an isolated dissection of the right external iliac artery. The patient had intact distal pulses and no other abnormal findings. He was admitted to the intensive care unit to control his high blood pressure with antihypertensive medications. The patient recovered well and was discharged home in stable condition with antiplatelet and antihypertensive therapy. The follow-up with the patient continued for one year.
CONCLUSIONS: Given the rarity of this disease, the treatment protocols and outcomes are still a matter of ongoing debate. Complicated cases with rupture should be treated on an emergency basis using open and endovascular repairs. In asymptomatic and symptomatic patients without rupture, medical treatment and possibly endovascular treatments are considered.
CONCLUSIONS: Conservative management of uncomplicated asymptomatic IAD should be considered as first-line therapy.
METHODS: Here, we present the case of a 45-year-old man who presented with right lower quadrant pain and hypertension as well as normal laboratory results. A contrast-enhanced computed tomography (CT) scan of the abdomen revealed an isolated dissection of the right external iliac artery. The patient had intact distal pulses and no other abnormal findings. He was admitted to the intensive care unit to control his high blood pressure with antihypertensive medications. The patient recovered well and was discharged home in stable condition with antiplatelet and antihypertensive therapy. The follow-up with the patient continued for one year.
CONCLUSIONS: Given the rarity of this disease, the treatment protocols and outcomes are still a matter of ongoing debate. Complicated cases with rupture should be treated on an emergency basis using open and endovascular repairs. In asymptomatic and symptomatic patients without rupture, medical treatment and possibly endovascular treatments are considered.
CONCLUSIONS: Conservative management of uncomplicated asymptomatic IAD should be considered as first-line therapy.
摘要：
■自发性髂动脉夹层（IAD）是一种罕见的疾病，通常与结缔组织疾病相关。并发症包括由于灌注不良引起的缺血和由于破裂引起的出血。治疗方法取决于专业知识和表现症状;它们包括保守，血管内,和手术选择。
方法：这里，我们介绍了一例45岁男性患者,他表现为右下腹疼痛和高血压,实验室检查结果正常.腹部的对比增强计算机断层扫描（CT）扫描显示右外髂动脉孤立夹层。患者的远端脉搏完整，没有其他异常发现。他被送进重症监护室，用降压药控制他的高血压。患者恢复良好，病情稳定出院，接受抗血小板和抗高血压治疗。对患者的随访持续了一年。
结论：鉴于这种疾病的罕见性，治疗方案和结局仍是一个持续争论的问题.破裂的复杂病例应使用开放式和腔内修复术进行紧急治疗。在没有破裂的无症状和有症状的患者中，考虑了药物治疗和可能的血管内治疗。
结论：无并发症无症状IAD的保守治疗应被视为一线治疗。
方法：这里，我们介绍了一例45岁男性患者,他表现为右下腹疼痛和高血压,实验室检查结果正常.腹部的对比增强计算机断层扫描（CT）扫描显示右外髂动脉孤立夹层。患者的远端脉搏完整，没有其他异常发现。他被送进重症监护室，用降压药控制他的高血压。患者恢复良好，病情稳定出院，接受抗血小板和抗高血压治疗。对患者的随访持续了一年。
结论：鉴于这种疾病的罕见性，治疗方案和结局仍是一个持续争论的问题.破裂的复杂病例应使用开放式和腔内修复术进行紧急治疗。在没有破裂的无症状和有症状的患者中，考虑了药物治疗和可能的血管内治疗。
结论：无并发症无症状IAD的保守治疗应被视为一线治疗。
