Effectiveness of the conservative therapy for spontaneous isolated iliac artery dissection: Preliminary results

Purpose: To investigate the effectiveness of conservative therapy for spontaneous isolated iliac artery dissection (SIIAD). Methods: From February 2006 to May 2016, all patients with SIIAD were included and analyzed. The diagnosis of SIIAD was made based on contrast-enhanced computed tomography. The imaging morphologic characteristics, treatments, and outcomes for each patient were analyzed. Results: A total of 11 patients (10 male and 1 female, age 71.1 +/- 7.8 years) were included in this study. Of the 11 patients, 8 patients were asymptomatic and the SIIADs were discovered during the course of computed tomography for other diseases, and 3 patients were symptomatic. Initial computed tomography findings: iliac arterial calcification (n=7); compression of the true lumen (n=6), with stenosis of the true lumen from 25% to 50% (n=3) and >= 50% (n=3); thrombosed false lumen partially (n=4), and no thrombosis in false lumen (n=7); dissecting aneurysm (n=11); entry points (n=11); re-entry points (n=1); no dissection extended to the internal iliac or common femoral artery. Conservative treatment was performed in six patients, and the remaining five patients need no treatment. During 23.3 +/- 14.2 months follow-up, none recurred symptoms and signs of symptomatic SIIAD; partial remodeling of SIIAD was achieved in four patients, and the remaining seven patients with no change of SIIAD. There was no presence of new false lumen enhancement on contrast-enhanced computed tomography during follow-up. Conclusions: SIIAD without arterial rupture or lower limb necrosis can be safely treated with conservative therapy.