Optimal medical treatment versus endovascular aortic repair in uncomplicated isolated abdominal aortic dissection

Objective: To report the results of optimal medical treatment (OMT) and endovascular aortic repair (EVAR) in patients with uncomplicated isolated abdominal dissection (IAAD). Methods: A retrospective review 96 consecutive IAAD (uIAAD) managed at a single tertiary vascular unit between January 2011 July 2021 was conducted. Standard methods for univariate survival analyses were used. The primary outcomes all-cause mortality. Secondary end points included uIAAD progression, interventional complications, follow-up intervention. Results: Initially, 53.1% (51/96) OMT. No in-hospital deaths occurred. During follow-up, three died, two who initially OMT subsequently required surgical management, respectively. 46.9% (45/96) underwent EVAR. One patient died during hospital admission; nine had an endoleak after operation one needed reintervention. Furthermore, five died; four reoperation, surgery treatments. overall long-term mortality 8.4%, intervention rate 9.5% (median 54 months; interquartile range, 33-81 months) no significant difference groups. Of note, 12 (12.6%) suffered which higher group than EVAR (10 [19.6%] vs 2 [4.5%]; P = .03). Conclusions: may be safely by regular surveillance, despite risk disease progression. Compared OMT, could significantly prevent For anatomically suitable progression are unresponsive to pre-emptive is safe feasible option.