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Therapeutic regimen options for isolated superior mesenteric artery dissection.
Vasc Endovascular Surg. 2012 Apr; 46(3):277-82.VE

Abstract

OBJECTIVE

To summarize the reproducible experience obtained during the treatment of superior mesenteric artery dissection (SMAD) and to investigate the therapeutic options for this condition.

METHODS

The clinical data from 10 patients with SMAD were retrospectively analyzed, including 6 patients receiving conservative therapy, 2 patients receiving endovascular stenting, 1 patient receiving dissecting aneurysm resection plus vascular prosthesis grafting, and 1 patient receiving thrombectomy plus intimectomy.

RESULTS

For the 6 patients subjected to the conservative therapy, the symptoms were thoroughly under control without relapse during the follow-up; for the 2 patients receiving endovascular stenting, the computed tomography (CT) examination performed during the follow-up demonstrated a patent true lumen and an occluded false lumen; for the patient with dissecting aneurysm resection plus vascular prosthesis grafting, a short dissection was observed at the distal end of the vascular prosthesis but without progression during the 14-month follow-up period; for the patient with thrombectomy plus intimectomy, postoperatively, the patient experienced diarrhea, body weight loss, and hypoproteinemia, and CT scanning demonstrated segmental SMA occlusions, which were not fully remitted by conservative therapy until the application of endovascular stenting 4 months later.

CONCLUSIONS

The therapeutic regimen for isolated SMAD should be established based on the clinical symptoms of the patient and the hemodynamic status in SMA. The conservative therapy is mainly indicated for the asymptomatic patients or those with short-term symptoms, while the endovascular or surgical therapy should be recommended for those with persistent intestinal ischemia-related symptoms, rupture of artery, and/or obvious aneurysmal false lumen dilation at a high risk of rupture.

Authors+Show Affiliations

Department of Vascular Surgery, Second Hospital Affiliated to Soochow University, Soochow, China.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22407428

Citation

Zhang, Xicheng, et al. "Therapeutic Regimen Options for Isolated Superior Mesenteric Artery Dissection." Vascular and Endovascular Surgery, vol. 46, no. 3, 2012, pp. 277-82.
Zhang X, Sun Y, Chen Z, et al. Therapeutic regimen options for isolated superior mesenteric artery dissection. Vasc Endovascular Surg. 2012;46(3):277-82.
Zhang, X., Sun, Y., Chen, Z., & Li, X. (2012). Therapeutic regimen options for isolated superior mesenteric artery dissection. Vascular and Endovascular Surgery, 46(3), 277-82. https://doi.org/10.1177/1538574411434162
Zhang X, et al. Therapeutic Regimen Options for Isolated Superior Mesenteric Artery Dissection. Vasc Endovascular Surg. 2012;46(3):277-82. PubMed PMID: 22407428.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Therapeutic regimen options for isolated superior mesenteric artery dissection. AU - Zhang,Xicheng, AU - Sun,Yuan, AU - Chen,Zhaolei, AU - Li,Xiaoqiang, Y1 - 2012/03/09/ PY - 2012/3/13/entrez PY - 2012/3/13/pubmed PY - 2012/9/5/medline SP - 277 EP - 82 JF - Vascular and endovascular surgery JO - Vasc Endovascular Surg VL - 46 IS - 3 N2 - OBJECTIVE: To summarize the reproducible experience obtained during the treatment of superior mesenteric artery dissection (SMAD) and to investigate the therapeutic options for this condition. METHODS: The clinical data from 10 patients with SMAD were retrospectively analyzed, including 6 patients receiving conservative therapy, 2 patients receiving endovascular stenting, 1 patient receiving dissecting aneurysm resection plus vascular prosthesis grafting, and 1 patient receiving thrombectomy plus intimectomy. RESULTS: For the 6 patients subjected to the conservative therapy, the symptoms were thoroughly under control without relapse during the follow-up; for the 2 patients receiving endovascular stenting, the computed tomography (CT) examination performed during the follow-up demonstrated a patent true lumen and an occluded false lumen; for the patient with dissecting aneurysm resection plus vascular prosthesis grafting, a short dissection was observed at the distal end of the vascular prosthesis but without progression during the 14-month follow-up period; for the patient with thrombectomy plus intimectomy, postoperatively, the patient experienced diarrhea, body weight loss, and hypoproteinemia, and CT scanning demonstrated segmental SMA occlusions, which were not fully remitted by conservative therapy until the application of endovascular stenting 4 months later. CONCLUSIONS: The therapeutic regimen for isolated SMAD should be established based on the clinical symptoms of the patient and the hemodynamic status in SMA. The conservative therapy is mainly indicated for the asymptomatic patients or those with short-term symptoms, while the endovascular or surgical therapy should be recommended for those with persistent intestinal ischemia-related symptoms, rupture of artery, and/or obvious aneurysmal false lumen dilation at a high risk of rupture. SN - 1938-9116 UR - https://www.unboundmedicine.com/medline/citation/22407428/Therapeutic_regimen_options_for_isolated_superior_mesenteric_artery_dissection_ L2 - https://journals.sagepub.com/doi/10.1177/1538574411434162?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -