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Percutaneous endovascular reconstruction with bare stent implantation for isolated superior mesenteric artery dissection.
Vasc Endovascular Surg 2014 Jul-Aug; 48(5-6):406-11VE

Abstract

BACKGROUND

Spontaneous isolated superior mesenteric artery dissection (ISMAD) is exceedingly rare. The therapeutic options range from observation to medical treatment to surgery or endovascular repair. We present our experience of the clinical management of ISMADs.

METHODS

Sixteen patients with ISMAD from January 2008 to July 2012 were retrospectively analyzed. The decision to intervene was based on anatomic suitability, patient comorbidities, and symptoms. Percutaneous endovascular reconstruction with bare stents was carried out in 7 patients in this study, for patients with persistent abdominal pain despite conservative treatment or signs of bowel ischemia. The patients were kept on antiplatelet therapy from 6 to 10 months postoperatively.

RESULTS

All attempted bare stent placements were successfully accomplished without any treatment-related complication. Of the 7 patients with ISMADs, 4 were treated by single stents, 2 by double overlapping stents, and 1 by triple overlapping stents. The abdominal pain alleviated after procedure and disappeared gradually within 3 days. None of the patients had ISMAD symptoms during follow-up (median, 21.7 months; range, 11-32 months). Follow-up computed tomography (CT) and CT angiography revealed patent stent and patent superior mesenteric artery (SMA) branches with complete obliteration of the dissection.

CONCLUSION

Isolated SMA dissection may be managed successfully in a variety of ways based on the clinical symptoms. In this small series, percutaneous endovascular reconstruction with bare stent implantation is a feasible treatment choice with a high success rate and good clinical outcome.

Authors+Show Affiliations

Department of Radiology, First Hospital Affiliated to Nanjing Medical University, Nanjing, China Department of Interventional Radiology, Northern Jiangsu People's Hospital, Yangzhou, China.Department of Vascular Surgery, Northern Jiangsu People's Hospital, Yangzhou, China.Department of Interventional Radiology, Northern Jiangsu People's Hospital, Yangzhou, China.Department of Radiology, First Hospital Affiliated to Nanjing Medical University, Nanjing, China shihb@vip.sina.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25232023

Citation

Lü, Peng-Hua, et al. "Percutaneous Endovascular Reconstruction With Bare Stent Implantation for Isolated Superior Mesenteric Artery Dissection." Vascular and Endovascular Surgery, vol. 48, no. 5-6, 2014, pp. 406-11.
Lü PH, Zhang XC, Wang LF, et al. Percutaneous endovascular reconstruction with bare stent implantation for isolated superior mesenteric artery dissection. Vasc Endovascular Surg. 2014;48(5-6):406-11.
Lü, P. H., Zhang, X. C., Wang, L. F., & Shi, H. B. (2014). Percutaneous endovascular reconstruction with bare stent implantation for isolated superior mesenteric artery dissection. Vascular and Endovascular Surgery, 48(5-6), pp. 406-11. doi:10.1177/1538574414543275.
Lü PH, et al. Percutaneous Endovascular Reconstruction With Bare Stent Implantation for Isolated Superior Mesenteric Artery Dissection. Vasc Endovascular Surg. 2014;48(5-6):406-11. PubMed PMID: 25232023.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Percutaneous endovascular reconstruction with bare stent implantation for isolated superior mesenteric artery dissection. AU - Lü,Peng-Hua, AU - Zhang,Xi-Cheng, AU - Wang,Li-Fu, AU - Shi,Hai-Bin, PY - 2014/9/19/entrez PY - 2014/9/19/pubmed PY - 2015/6/2/medline KW - bare stent KW - dissection KW - endovascular reconstruction KW - superior mesenteric artery SP - 406 EP - 11 JF - Vascular and endovascular surgery JO - Vasc Endovascular Surg VL - 48 IS - 5-6 N2 - BACKGROUND: Spontaneous isolated superior mesenteric artery dissection (ISMAD) is exceedingly rare. The therapeutic options range from observation to medical treatment to surgery or endovascular repair. We present our experience of the clinical management of ISMADs. METHODS: Sixteen patients with ISMAD from January 2008 to July 2012 were retrospectively analyzed. The decision to intervene was based on anatomic suitability, patient comorbidities, and symptoms. Percutaneous endovascular reconstruction with bare stents was carried out in 7 patients in this study, for patients with persistent abdominal pain despite conservative treatment or signs of bowel ischemia. The patients were kept on antiplatelet therapy from 6 to 10 months postoperatively. RESULTS: All attempted bare stent placements were successfully accomplished without any treatment-related complication. Of the 7 patients with ISMADs, 4 were treated by single stents, 2 by double overlapping stents, and 1 by triple overlapping stents. The abdominal pain alleviated after procedure and disappeared gradually within 3 days. None of the patients had ISMAD symptoms during follow-up (median, 21.7 months; range, 11-32 months). Follow-up computed tomography (CT) and CT angiography revealed patent stent and patent superior mesenteric artery (SMA) branches with complete obliteration of the dissection. CONCLUSION: Isolated SMA dissection may be managed successfully in a variety of ways based on the clinical symptoms. In this small series, percutaneous endovascular reconstruction with bare stent implantation is a feasible treatment choice with a high success rate and good clinical outcome. SN - 1938-9116 UR - https://www.unboundmedicine.com/medline/citation/25232023/Percutaneous_endovascular_reconstruction_with_bare_stent_implantation_for_isolated_superior_mesenteric_artery_dissection_ L2 - http://journals.sagepub.com/doi/full/10.1177/1538574414543275?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -