Changes in Abdominal Artery Diameter in Patients Treated for Acute Aortic Dissection

TL;DR

This study examines changes in abdominal artery diameter before and after surgery in patients with acute aortic dissection, finding significant differences that may relate to mesenteric ischemia.

Contribution

The study provides the first data on arterial diameter changes in patients with acute aortic dissection, linking these changes to potential mesenteric ischemia.

Findings

Superior mesenteric and renal arteries showed significant diameter changes pre- and post-surgery (p < 0.001).

Inferior mesenteric artery occlusion was more common in patients with abdominal aortic dissection.

True and false lumen differences were significant after the frozen elephant trunk procedure.

Abstract

Background: Mesenteric ischemia significantly increases intraoperative mortality in patients with acute aortic dissection (AAD). The arterial diameter affects both blood flow and arterial resistance. There are no data in the literature on changes in arterial diameter in patients with AAD. It has already been demonstrated that changes in arterial diameter can be observed in patients with non-occlusive intestinal ischemia. The aim of this study was to compare the arterial branches of the abdominal aorta in patients with AAD preoperatively and postoperatively. Methods: Preoperative and postoperative contrast-enhanced computed tomography scans of 25 patients who had undergone the frozen elephant trunk procedure for the treatment of AAD were reconstructed and retrospectively analyzed with detailed medical data of the patients. Results: In patients without AAD at the level of the abdominal aorta, statistically significant differences were observed when comparing the diameter of the superior mesenteric artery (p < 0.001) and the renal arteries (p < 0.001) between preoperative and postoperative scans. Occlusion of the inferior mesenteric artery was more common in patients with AAD involving the abdominal aorta. Statistically significant differences in true and false lumen were observed at each level of the abdominal aorta after a successful frozen elephant trunk procedure. Conclusion: Significant changes in visceral artery diameter were observed at the abdominal aortic level in patients both with and without aortic dissection. Chronic or non-occlusive mesenteric ischemia may be associated with a lack of adjustment in arterial diameter. Patients with AAD of the abdominal aorta are more susceptible to occlusion of the inferior mesenteric artery.

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