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Treatment results for spontaneous isolated superior mesenteric artery dissection according to our previous guidelines and collective literature review.
Ann Vasc Surg 2014; 28(7):1595-601AV

Abstract

BACKGROUND

Isolated superior mesenteric artery dissection (ISMAD) is not a rare disease. However, its optimal treatment strategy has not yet been established.

METHODS

This study included 13 consecutive patients with ISMAD who were treated between April 2010 and July 2013 according to published treatment guidelines. Through a literature search, 10 studies on treatments and outcomes for ISMAD that were published from 2007 to the present were analyzed.

RESULTS

In the present study, 11 patients had acute onset abdominal pain and 2 patients were asymptomatic. Twelve patients were treated with conservative treatment, whereas 1 patient underwent coil embolization. In the literature review, initial conservative treatment, endovascular procedure, and surgical repair were done in 172, 25, and 14 patients, respectively. Bowel resection was done in 8 patients (3.7%) due to bowel necrosis. Conservative treatment failed in 15 patients (6.8%) during follow-up.

CONCLUSIONS

If bowel necrosis or arterial rupture was not present, conservative treatment of ISMAD was a safe and effective treatment. Aneurysmal type IV patients on computed tomography scan should be carefully followed up, and if there is a recurrence of pain or aneurysmal progression, an endovascular procedure could be safely performed.

Authors+Show Affiliations

College of Nursing, Eulji University, Daejeon, Korea.Department of Surgery, Eulji University Hospital, Daejeon, Korea. Electronic address: isunjoe@gmail.com.Department of Surgery, Eulji University Hospital, Daejeon, Korea.Department of Surgery, Eulji University Hospital, Daejeon, Korea.Department of Surgery, Eulji University Hospital, Daejeon, Korea.Department of Surgery, Eulji University Hospital, Daejeon, Korea.Department of Surgery, Eulji University Hospital, Daejeon, Korea.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

24858595

Citation

Ahn, Hye Young, et al. "Treatment Results for Spontaneous Isolated Superior Mesenteric Artery Dissection According to Our Previous Guidelines and Collective Literature Review." Annals of Vascular Surgery, vol. 28, no. 7, 2014, pp. 1595-601.
Ahn HY, Cho BS, Mun YS, et al. Treatment results for spontaneous isolated superior mesenteric artery dissection according to our previous guidelines and collective literature review. Ann Vasc Surg. 2014;28(7):1595-601.
Ahn, H. Y., Cho, B. S., Mun, Y. S., Jang, J. H., Kim, C. N., Lee, M. S., & Kang, Y. J. (2014). Treatment results for spontaneous isolated superior mesenteric artery dissection according to our previous guidelines and collective literature review. Annals of Vascular Surgery, 28(7), pp. 1595-601. doi:10.1016/j.avsg.2014.04.007.
Ahn HY, et al. Treatment Results for Spontaneous Isolated Superior Mesenteric Artery Dissection According to Our Previous Guidelines and Collective Literature Review. Ann Vasc Surg. 2014;28(7):1595-601. PubMed PMID: 24858595.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment results for spontaneous isolated superior mesenteric artery dissection according to our previous guidelines and collective literature review. AU - Ahn,Hye Young, AU - Cho,Byung Sun, AU - Mun,Yun Su, AU - Jang,Je Ho, AU - Kim,Chang Nam, AU - Lee,Moon Soo, AU - Kang,Yoon Jung, Y1 - 2014/05/21/ PY - 2014/02/11/received PY - 2014/04/08/revised PY - 2014/04/16/accepted PY - 2014/5/27/entrez PY - 2014/5/27/pubmed PY - 2015/5/27/medline SP - 1595 EP - 601 JF - Annals of vascular surgery JO - Ann Vasc Surg VL - 28 IS - 7 N2 - BACKGROUND: Isolated superior mesenteric artery dissection (ISMAD) is not a rare disease. However, its optimal treatment strategy has not yet been established. METHODS: This study included 13 consecutive patients with ISMAD who were treated between April 2010 and July 2013 according to published treatment guidelines. Through a literature search, 10 studies on treatments and outcomes for ISMAD that were published from 2007 to the present were analyzed. RESULTS: In the present study, 11 patients had acute onset abdominal pain and 2 patients were asymptomatic. Twelve patients were treated with conservative treatment, whereas 1 patient underwent coil embolization. In the literature review, initial conservative treatment, endovascular procedure, and surgical repair were done in 172, 25, and 14 patients, respectively. Bowel resection was done in 8 patients (3.7%) due to bowel necrosis. Conservative treatment failed in 15 patients (6.8%) during follow-up. CONCLUSIONS: If bowel necrosis or arterial rupture was not present, conservative treatment of ISMAD was a safe and effective treatment. Aneurysmal type IV patients on computed tomography scan should be carefully followed up, and if there is a recurrence of pain or aneurysmal progression, an endovascular procedure could be safely performed. SN - 1615-5947 UR - https://www.unboundmedicine.com/medline/citation/24858595/Treatment_results_for_spontaneous_isolated_superior_mesenteric_artery_dissection_according_to_our_previous_guidelines_and_collective_literature_review_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0890-5096(14)00250-7 DB - PRIME DP - Unbound Medicine ER -