English Polski
Vol 23, No 1 (2017)
Case report
Published online: 2017-05-12

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Acute onset of lower limb claudication as a manifestation of a spontaneous common iliac artery dissection

Lukasz Hapka, Grzegorz Halena
Acta Angiologica 2017;23(1):9-12.

Abstract

Isolated abdominal aortic dissection constitutes a relatively small percentage of all aortic dissections. In this paper we present a case of a 59-year-old man who reported to the hospital because of the sudden appearance of intermittent claudication of his left lower limb. After establishing the diagnosis the patient was qualified for endovascular treatment due to dissection involving the final 1 cm of his abdominal aorta and extending to his left common iliac artery with significant true lumen compression. Stent was implanted into the left common iliac artery with almost complete occlusion of the false lumen and expansion of the true lumen of his iliac artery. During the 70-month follow-up we achieved a good result with evidence of stent patency and no signs of expansion of the false lumen. The paper discusses the epidemiology, aetiology, diagnosis and treatment of isolated abdominal dissections.

References

  1. Graham D, Alexander JJ, Franceschi D, et al. The management of localized abdominal aortic dissections. J Vasc Surg. 1988; 8(5): 582–591.
  2. Hirst AE, Johns VJ, Kime SW. Dissecting aneurysm of the aorta: a review of 505 cases. Medicine (Baltimore). 1958; 37(3): 217–279.
  3. Trimarchi S, Tsai T, Eagle KA, et al. International Registry of Acute Aortic Dissection (IRAD) investigators. Acute abdominal aortic dissection: insight from the International Registry of Acute Aortic Dissection (IRAD). J Vasc Surg. 2007; 46(5): 913–919.
  4. Roberts CS, Roberts WC. Aortic dissection with the entrance tear in abdominal aorta. Am Heart J. 1991; 121(6 Pt 1): 1834–1835.
  5. Weibull H, Bergqvist D, Jonsson K, et al. Complications after percutaneous transluminal angioplasty in the iliac, femoral, and popliteal arteries. J Vasc Surg. 1987; 5(5): 681–686.
  6. Tuech JJ, Villapadierna F, Singland JD, et al. Blunt injury to the common iliac artery. Eur J Vasc Endovasc Surg. 2000; 20(1): 47–50.
  7. Cook PS, Erdoes LS, Selzer PM, et al. Dissection of the external iliac artery in highly trained athletes. J Vasc Surg. 1995; 22(2): 173–177.
  8. Akashi H, Nata S, Kanaya K, et al. Spontaneous dissection of the iliac artery in a patient with fibromuscular dysplasia. Ann Vasc Surg. 2010; 24(7): 952.e13–952.e16.
  9. Ida H, Taniguchi N. Isolated common iliac artery dissection and aneurysm. BMJ Case Rep. 2016; 2016.
  10. Jonker FHW, Schlösser FJV, Moll FL, et al. Dissection of the abdominal aorta. Current evidence and implications for treatment strategies: a review and meta-analysis of 92 patients. J Endovasc Ther. 2009; 16(1): 71–80.
  11. Sedivy P, El Samman K, Slais M, et al. A spontaneous isolated dissection of the external iliac artery in a roofer. Bratisl Lek Listy. 2011; 112(7): 407–409.
  12. Teh LG, Sieunarine K, Van Schie G, et al. Spontaneous common iliac artery dissection after exercise. J Endovasc Ther. 2003; 10(1): 163–166.
  13. Thalhammer C, Aschwanden M, Blum B, et al. Unusual cause of intermittent claudication. Vasa. 2004; 33(4): 257–259.
  14. Hirai S, Hamanaka Y, Mitsui N, et al. Spontaneous and isolated dissection of the external iliac artery: a case report. Ann Thorac Cardiovasc Surg. 2002; 8(3): 180–182.