Kang SH, et al. - Researchers retrospectively reviewed 16 patients presenting with symptomatic Spontaneous Isolated Coeliac Artery Dissection (SICAD) from September 2006 to October 2018 in order to describe the mid- to long-term outcomes of conservative management and endovascular intervention of SICAD treatment. Because of aneurysmal dilatation or distal hypoperfusion, early intervention was done in 4 patients. The delayed intervention was undertaken in four patients showing a progression of disease following receipt of conservative management. One of these four patients failed in delayed intervention because of extensive thrombi completely occluding the hepatic artery despite the prevention of further hepatic ischemia by collaterals. Conservative management was undertaken in the remaining eight patients with the achievement of symptomatic improvement in all; three of these (37.5%) exhibited regression of the disease, one (12.5%) exhibited partial regression, and five (62.5%) had no change in intimal flap or thrombosis. During the median follow up duration of 77.3 (range 34.3–118.9) months among the seven patients who underwent successful intervention, all stenting remained patent during. These findings suggest a possible necessity for early intervention in symptomatic SICAD patients in over 50% of patients and the achievement of durable long term outcomes with endovascular stenting.