{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T10:01:33Z","timestamp":1775642493824,"version":"3.50.1"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T00:00:00Z","timestamp":1677110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Isolated abdominal aortic dissection (IAAD) is extremely rare, with its optimal treatment and intervention timing remaining poorly understood. We aimed to study the natural history of IAAD and facilitate better clinical decision.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients admitted to our institution from January 2016 to April 2021 were enrolled and followed up prospectively. All-cause death was taken as the primary endpoint.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 68 patients with IAAD were included. The mean age at presentation was 61.2\u2009\u00b1\u200914.8 (Range: 26.0, 93.0) years and 55 (80.9%) were male. A total of 38 (55.9%) patients were treated conservatively, 27 (39.7%) received endovascular aneurysm repair (EVAR), and 3 (4.4%) underwent open surgery. After a mean follow-up of 2.4\u2009years (Range: 0.1, 5.5), 9 (13.2%) patients died, 8 of whom (21.0%) were treated conservatively and 1 EVAR (3.7%). Compared with EVAR\/open surgery, patient treated conservatively had a much worse survival (<jats:italic>p<\/jats:italic>\u2009=\u20090.043). There was no significant difference between different IAAD aortic sizes regarding mortality (<jats:italic>p<\/jats:italic>\u2009=\u20090.220). Patients with completely thrombosed false lumen fared improved survival rate, followed by partial thrombosis and patency, respectively, although not significantly (<jats:italic>p<\/jats:italic>\u2009=\u20090.190). No significant difference was observed between male and female concerning survival rate (<jats:italic>p<\/jats:italic>\u2009=\u20090.970). Patients without symptoms had a significantly improved survival (<jats:italic>p<\/jats:italic>\u2009=\u20090.048).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>On the basis of patients\u2019 preference and surgeons\u2019 experience, a more aggressive treatment regimen for IAAD should be considered, with EVAR being the first choice, especially for those with persistent symptoms and patent false lumen, regardless of sex, age, or aortic size.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2023.1002832","type":"journal-article","created":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T12:42:39Z","timestamp":1677156159000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Natural history of isolated abdominal aortic dissection: A prospective cohort study"],"prefix":"10.3389","volume":"10","author":[{"given":"Jinlin","family":"Wu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanfen","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donglin","family":"Zhuang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunqing","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zerui","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jue","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruixin","family":"Fan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tucheng","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"16053","DOI":"10.1038\/nrdp.2016.53","article-title":"Aortic dissection","volume":"2","author":"Nienaber","year":"2016","journal-title":"Nat Rev Dis Primers"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2046","DOI":"10.1016\/j.jvs.2019.04.467","article-title":"A systematic review and meta-analysis of isolated abdominal aortic dissection","volume":"70","author":"Wu","year":"2019","journal-title":"J Vasc Surg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1198","DOI":"10.1016\/j.jvs.2020.07.090","article-title":"Incidence and natural history of isolated abdominal aortic dissection: a population-based assessment from 1995 to 2015","volume":"73","author":"Sen","year":"2021","journal-title":"J Vasc Surg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1495","DOI":"10.1016\/j.jclinepi.2007.11.008","article-title":"The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies","author":"Von Elm","year":"2014","journal-title":"J Clin Epidemiol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1056\/NEJMoa063232","article-title":"Partial thrombosis of the false lumen in patients with acute type B aortic dissection","volume":"357","author":"Tsai","year":"2007","journal-title":"N Engl J Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1093\/ejcts\/ezz209","article-title":"Subacute\/chronic type A aortic dissection: a retrospective cohort study","volume":"57","author":"Wu","year":"2019","journal-title":"Eur J Cardio Thorac"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"e27","DOI":"10.1016\/j.jacc.2010.02.015","article-title":"ACCF\/AHA\/AATS\/ACR\/ASA\/SCA\/SCAI\/SIR\/STS\/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease. 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