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Clinical and angiographic follow-up of spontaneous isolated superior mesenteric artery dissection.
Eur J Vasc Endovasc Surg. 2009 May; 37(5):572-7.EJ

Abstract

OBJECTIVES

To observe the clinical features and angiographic findings in patients with a spontaneous isolated superior mesenteric artery dissection (SISMAD) and to identify any correlation between them.

METHODS

From a single institution, 32 patients (22 symptomatic patients at presentation; mean age 54years; men 97%) with SISMAD were retrospectively reviewed. All patients were available for clinical follow-up after treatment (conservative, n=28, 88%, open or endovascular superior mesenteric artery (SMA) reconstruction, n=4, 12%), and follow-up CT scans were available in 28 patients (mean 22months, range 1-80months).

RESULTS

We found a positive correlation between pain severity and dissection length (p=0.03, rho=0.50, Spearman's partial correlation analysis). After conservative treatment, only one patient (3%) required bowel resection, and there was no difference in outcome between patients who were treated with anticoagulation or anti-platelet therapy and those who were not (p=1.00, Fisher's exact test). No patients had progression of their lesion on the follow-up CT angiography.

CONCLUSIONS

In SISMAD patients, dissection length is positively associated with more severe clinical symptoms. After conservative treatment, we observed a benign clinical course and no CT progression of the dissection, even without anticoagulation or anti-platelet therapy. Based on our observation, patients with SISMAD can be treated conservatively without anticoagulation therapy.

Authors+Show Affiliations

Division of Vascular Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Ilwon-dong #50, Gangnam-gu, Seoul 135-710, South Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19208448

Citation

Yun, W S., et al. "Clinical and Angiographic Follow-up of Spontaneous Isolated Superior Mesenteric Artery Dissection." European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, vol. 37, no. 5, 2009, pp. 572-7.
Yun WS, Kim YW, Park KB, et al. Clinical and angiographic follow-up of spontaneous isolated superior mesenteric artery dissection. Eur J Vasc Endovasc Surg. 2009;37(5):572-7.
Yun, W. S., Kim, Y. W., Park, K. B., Cho, S. K., Do, Y. S., Lee, K. B., Kim, D. I., & Kim, D. K. (2009). Clinical and angiographic follow-up of spontaneous isolated superior mesenteric artery dissection. European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, 37(5), 572-7. https://doi.org/10.1016/j.ejvs.2008.12.010
Yun WS, et al. Clinical and Angiographic Follow-up of Spontaneous Isolated Superior Mesenteric Artery Dissection. Eur J Vasc Endovasc Surg. 2009;37(5):572-7. PubMed PMID: 19208448.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and angiographic follow-up of spontaneous isolated superior mesenteric artery dissection. AU - Yun,W S, AU - Kim,Y W, AU - Park,K B, AU - Cho,S K, AU - Do,Y S, AU - Lee,K B, AU - Kim,D I, AU - Kim,D K, Y1 - 2009/02/08/ PY - 2008/08/14/received PY - 2008/12/15/accepted PY - 2009/2/12/entrez PY - 2009/2/12/pubmed PY - 2009/5/15/medline SP - 572 EP - 7 JF - European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery JO - Eur J Vasc Endovasc Surg VL - 37 IS - 5 N2 - OBJECTIVES: To observe the clinical features and angiographic findings in patients with a spontaneous isolated superior mesenteric artery dissection (SISMAD) and to identify any correlation between them. METHODS: From a single institution, 32 patients (22 symptomatic patients at presentation; mean age 54years; men 97%) with SISMAD were retrospectively reviewed. All patients were available for clinical follow-up after treatment (conservative, n=28, 88%, open or endovascular superior mesenteric artery (SMA) reconstruction, n=4, 12%), and follow-up CT scans were available in 28 patients (mean 22months, range 1-80months). RESULTS: We found a positive correlation between pain severity and dissection length (p=0.03, rho=0.50, Spearman's partial correlation analysis). After conservative treatment, only one patient (3%) required bowel resection, and there was no difference in outcome between patients who were treated with anticoagulation or anti-platelet therapy and those who were not (p=1.00, Fisher's exact test). No patients had progression of their lesion on the follow-up CT angiography. CONCLUSIONS: In SISMAD patients, dissection length is positively associated with more severe clinical symptoms. After conservative treatment, we observed a benign clinical course and no CT progression of the dissection, even without anticoagulation or anti-platelet therapy. Based on our observation, patients with SISMAD can be treated conservatively without anticoagulation therapy. SN - 1532-2165 UR - https://www.unboundmedicine.com/medline/citation/19208448/Clinical_and_angiographic_follow_up_of_spontaneous_isolated_superior_mesenteric_artery_dissection_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1078-5884(08)00690-4 DB - PRIME DP - Unbound Medicine ER -