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Spontaneous dissection of the splanchnic arteries: CT findings, treatment, and outcome.
AJR Am J Roentgenol 2013; 200(1):219-25AA

Abstract

OBJECTIVE

The purpose of this study was to describe the various CT findings of isolated spontaneous splanchnic artery dissection and the treatment options and outcomes.

MATERIALS AND METHODS

From January 1999 to May 2008, splanchnic artery dissection was diagnosed through CT angiography in 34 patients (28 men, six women) without recent trauma or aortic disease. All patients were classified as having either symptomatic (n = 19) or asymptomatic (n = 15) dissection. We analyzed imaging findings of intimal flap, aneurysmal dilatation, thrombosed false lumen, periarterial fatty infiltration, branch vessel involvement, bowel ischemic signs, and the extent of involvement of each artery with each treatment method and the outcomes.

RESULTS

Intimal flap (n = 37 [88.1%]; symptomatic, 22; asymptomatic, 15), thrombosed false lumen (n = 27 [64.3%]; symptomatic, 19; asymptomatic, 8), and aneurysmal dilatation (n = 22 [52.4%]; symptomatic, 14; asymptomatic, 8) were seen. Periarterial fatty infiltration and branch vessel involvement differed between the symptomatic and asymptomatic groups (p < 0.01). Renal artery dissection was found in six patients (symptomatic, 3; asymptomatic, 3). Six patients were lost to follow-up. Treatments included conservative management without anticoagulation therapy (n = 19; symptomatic, 8; asymptomatic, 11), endovascular stent insertions (n = 6; symptomatic, 6; asymptomatic, 0), and surgery (n = 3; symptomatic, 3; asymptomatic, 0). Patients with a follow-up interval of more than 10 days had disease in a stationary state (n = 14; symptomatic, 4; asymptomatic, 10), were in improved condition (n = 12; symptomatic, 11; asymptomatic, 1), or had progression of disease (n = 2; symptomatic, 2; asymptomatic, 0).

CONCLUSION

Intimal flap, thrombosed false lumen, and aneurysmal dilatation are the most common CT findings of spontaneous splanchnic artery dissection. In splanchnic artery dissection, conservative management without anticoagulation had good outcome except in patients with bowel ischemia, aneurysmal dilatation three times larger than a normal segment, or progression of dissection.

Authors+Show Affiliations

Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23255765

Citation

Jung, Seung Chai, et al. "Spontaneous Dissection of the Splanchnic Arteries: CT Findings, Treatment, and Outcome." AJR. American Journal of Roentgenology, vol. 200, no. 1, 2013, pp. 219-25.
Jung SC, Lee W, Park EA, et al. Spontaneous dissection of the splanchnic arteries: CT findings, treatment, and outcome. AJR Am J Roentgenol. 2013;200(1):219-25.
Jung, S. C., Lee, W., Park, E. A., Jae, H. J., Chung, J. W., & Park, J. H. (2013). Spontaneous dissection of the splanchnic arteries: CT findings, treatment, and outcome. AJR. American Journal of Roentgenology, 200(1), pp. 219-25. doi:10.2214/AJR.11.7877.
Jung SC, et al. Spontaneous Dissection of the Splanchnic Arteries: CT Findings, Treatment, and Outcome. AJR Am J Roentgenol. 2013;200(1):219-25. PubMed PMID: 23255765.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spontaneous dissection of the splanchnic arteries: CT findings, treatment, and outcome. AU - Jung,Seung Chai, AU - Lee,Whal, AU - Park,Eun-Ah, AU - Jae,Hwan Jun, AU - Chung,Jin Wook, AU - Park,Jae Hyung, PY - 2012/12/21/entrez PY - 2012/12/21/pubmed PY - 2013/2/21/medline SP - 219 EP - 25 JF - AJR. American journal of roentgenology JO - AJR Am J Roentgenol VL - 200 IS - 1 N2 - OBJECTIVE: The purpose of this study was to describe the various CT findings of isolated spontaneous splanchnic artery dissection and the treatment options and outcomes. MATERIALS AND METHODS: From January 1999 to May 2008, splanchnic artery dissection was diagnosed through CT angiography in 34 patients (28 men, six women) without recent trauma or aortic disease. All patients were classified as having either symptomatic (n = 19) or asymptomatic (n = 15) dissection. We analyzed imaging findings of intimal flap, aneurysmal dilatation, thrombosed false lumen, periarterial fatty infiltration, branch vessel involvement, bowel ischemic signs, and the extent of involvement of each artery with each treatment method and the outcomes. RESULTS: Intimal flap (n = 37 [88.1%]; symptomatic, 22; asymptomatic, 15), thrombosed false lumen (n = 27 [64.3%]; symptomatic, 19; asymptomatic, 8), and aneurysmal dilatation (n = 22 [52.4%]; symptomatic, 14; asymptomatic, 8) were seen. Periarterial fatty infiltration and branch vessel involvement differed between the symptomatic and asymptomatic groups (p < 0.01). Renal artery dissection was found in six patients (symptomatic, 3; asymptomatic, 3). Six patients were lost to follow-up. Treatments included conservative management without anticoagulation therapy (n = 19; symptomatic, 8; asymptomatic, 11), endovascular stent insertions (n = 6; symptomatic, 6; asymptomatic, 0), and surgery (n = 3; symptomatic, 3; asymptomatic, 0). Patients with a follow-up interval of more than 10 days had disease in a stationary state (n = 14; symptomatic, 4; asymptomatic, 10), were in improved condition (n = 12; symptomatic, 11; asymptomatic, 1), or had progression of disease (n = 2; symptomatic, 2; asymptomatic, 0). CONCLUSION: Intimal flap, thrombosed false lumen, and aneurysmal dilatation are the most common CT findings of spontaneous splanchnic artery dissection. In splanchnic artery dissection, conservative management without anticoagulation had good outcome except in patients with bowel ischemia, aneurysmal dilatation three times larger than a normal segment, or progression of dissection. SN - 1546-3141 UR - https://www.unboundmedicine.com/medline/citation/23255765/Spontaneous_dissection_of_the_splanchnic_arteries:_CT_findings_treatment_and_outcome_ L2 - http://www.ajronline.org/doi/full/10.2214/AJR.11.7877 DB - PRIME DP - Unbound Medicine ER -