The Oddball of Isolated Abdominal Aortic Dissection

Introduction: Isolated abdominal aortic dissection (IAAD) is a rare vascular emergency, accounting for 1.1%–4% of all aortic dissections, with limited literature on optimal management. Materials and Methods: This was a retrospective analysis of eight consecutive IAAD patients treated between 2017 and 2025 at three centers. Clinical characteristics, imaging findings, treatment strategies, and outcomes were evaluated. Results: There were 5 (62.5%) males and 3 (37.5%) females with a mean age of 43.63 years (range: 17–65). Dissection was spontaneous in 5 (62.5%) cases, blunt traumatic in 3 (37.5%) cases. Dissection was limited to the infrarenal segment in 5 (62.5%) cases, was juxtarenal in 2 (25%), and involved the suprarenal segment in 1 (12.5%) of the patients. Aneurysm formation was seen in 3 (37.5%) patients. Three (37.5%) cases of organ ischemia were identified: spinal cord ischemia in 2 and bowel and lower limb ischemia in 1 case. Treatment was conservative in 4 (50%), endovascular in 3 (37.5%), and open surgery in 1 (12.5%) patient. The 30-day mortality was 0%. Over a median follow-up of 20 months (IQR: 34.5), 1 patient (12.5%) died due to a cardiac cause. Conclusions: IAAD requires individualized management based on presentation and anatomic characteristics. Conservative management is initially appropriate for stable, uncomplicated IAAD; endovascular or surgical intervention is indicated for complications or aneurysm formation.