Peripheral vascular complications of aortic dissection

Background: The incidence and management of peripheral vascular complications of aortic dissection is unsettled. Patients and methods: Peripheral vascular complications of spontaneous aortic dissection were examined in a 5-year retrospective review. Patients who had peripheral vascular complications were categorized as group A; those without as group B. Results: Thirty-eitht major vessels were affected in 18 patients. No patient underwent a peripheral vascular procedure for complications of the carotid, subclavian, celiac, mesenteric, or renal arteries. Three patients underwent femorofemoral bypass for acute iliofemoral occlusion due to dissection. A fourth patient had repair of an iliac aneurysm that developed as a complication of chronic dissection. The mortality rate was 17% for group A, 9% for group B, and 10% overall. Following repair of the aortic dissection, the majority of the peripheral vascular complications resolved. Conclusions: Peripheral revascularization is infrequently required in aortic dissection following primary dissection repair.