BACKGROUND: The incidence and management of peripheral vascular compli
cations of aortic dissection is unsettled. PATIENTS AND METHODS: Perip
heral vascular complications of spontaneous aortic dissection were exa
mined in a 5-year retrospective review. Patients who had peripheral va
scular complications were categorized as group A; those without as gro
up B. RESULTS: Thirty-eight major vessels were affected in 18 patients
, No patient underwent a peripheral vascular procedure for complicatio
ns of the carotid, subclavian, celiac, mesenteric, or renal arteries,
Three patients underwent femorofemoral bypass for acute iliofemoral oc
clusion due to dissection, A fourth patient had repair of an iliac ane
urysm that developed as a complication of chronic dissection. The mort
ality rate was 17% for group A, 9% for group B, and 10% overall, Follo
wing repair of the aortic dissection, the majority of the peripheral v
ascular complications resolved. CONCLUSIONS: Peripheral revascularizat
ion is in-frequently required in aortic dissection following primary d
issection repair.