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Outcomes of Spontaneous Isolated Superior Mesenteric Artery Dissection Without Antithrombotic Use.
Eur J Vasc Endovasc Surg. 2018 Jan; 55(1):132-137.EJ

Abstract

OBJECTIVES

This study aimed to show the intention to treat results of treatment for spontaneous isolated superior mesenteric artery dissection (SISMAD) without anticoagulation or antiplatelet agents and the follow-up results of SISMAD according to the configuration on computed tomography (CT) scans.

DESIGN

Retrospective, observational single centre study METHODS: All cases of SISMAD were enrolled consecutively from 2006 onwards. There were 25 symptomatic and four asymptomatic patients in whom SISMAD was found incidentally. The SISMAD patients were treated using a consistent therapeutic strategy without antithrombotics. SISMAD was categorized into four types based on the configuration on CT scans by Yun's classification. Follow-up CT was performed at 3 months, 6 months, and yearly thereafter.

RESULTS

The median follow-up duration was 57 months (13-129 months). Improvement or complete resolution on CT scans, with no symptom recurrence, was seen in 27 patients. The non-invasive approach failed in three cases and two patients underwent further intervention. No patient died during the follow-up.

CONCLUSIONS

Weighing the risks versus benefits of antithrombotics and considering the benign nature of SISMAD, conservative treatment without antithrombotics might be sufficient in patients without evidence of bowel ischaemia or infarction on initial CT scan.

Authors+Show Affiliations

Department of Surgery, College of Medicine, Chung-Ang University, Republic of Korea.Department of Surgery, Ulsan University Hospital and University of Ulsan College of Medicine, Republic of Korea.Department of Surgery, Ulsan University Hospital and University of Ulsan College of Medicine, Republic of Korea. Electronic address: sjpark@uuh.ulsan.kr.Department of Surgery, Ulsan University Hospital and University of Ulsan College of Medicine, Republic of Korea.Department of Radiology, Ulsan University Hospital and University of Ulsan College of Medicine, Republic of Korea.Department of Radiology, Ulsan University Hospital and University of Ulsan College of Medicine, Republic of Korea.Department of Surgery, Ulsan University Hospital and University of Ulsan College of Medicine, Republic of Korea.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

29229279

Citation

Kim, Hyangkyoung, et al. "Outcomes of Spontaneous Isolated Superior Mesenteric Artery Dissection Without Antithrombotic Use." European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, vol. 55, no. 1, 2018, pp. 132-137.
Kim H, Park H, Park SJ, et al. Outcomes of Spontaneous Isolated Superior Mesenteric Artery Dissection Without Antithrombotic Use. Eur J Vasc Endovasc Surg. 2018;55(1):132-137.
Kim, H., Park, H., Park, S. J., Park, B. W., Hwang, J. C., Seo, Y. W., & Cho, H. R. (2018). Outcomes of Spontaneous Isolated Superior Mesenteric Artery Dissection Without Antithrombotic Use. European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, 55(1), 132-137. https://doi.org/10.1016/j.ejvs.2017.11.002
Kim H, et al. Outcomes of Spontaneous Isolated Superior Mesenteric Artery Dissection Without Antithrombotic Use. Eur J Vasc Endovasc Surg. 2018;55(1):132-137. PubMed PMID: 29229279.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of Spontaneous Isolated Superior Mesenteric Artery Dissection Without Antithrombotic Use. AU - Kim,Hyangkyoung, AU - Park,Hojong, AU - Park,Sang Jun, AU - Park,Bong Won, AU - Hwang,Jae Chol, AU - Seo,Young Woo, AU - Cho,Hong Rae, Y1 - 2017/12/08/ PY - 2017/04/29/received PY - 2017/11/08/accepted PY - 2017/12/13/pubmed PY - 2018/6/13/medline PY - 2017/12/13/entrez KW - Antithrombotic agents KW - Dissection KW - Mesenteric artery KW - Treatment outcome SP - 132 EP - 137 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 - 55 IS - 1 N2 - OBJECTIVES: This study aimed to show the intention to treat results of treatment for spontaneous isolated superior mesenteric artery dissection (SISMAD) without anticoagulation or antiplatelet agents and the follow-up results of SISMAD according to the configuration on computed tomography (CT) scans. DESIGN: Retrospective, observational single centre study METHODS: All cases of SISMAD were enrolled consecutively from 2006 onwards. There were 25 symptomatic and four asymptomatic patients in whom SISMAD was found incidentally. The SISMAD patients were treated using a consistent therapeutic strategy without antithrombotics. SISMAD was categorized into four types based on the configuration on CT scans by Yun's classification. Follow-up CT was performed at 3 months, 6 months, and yearly thereafter. RESULTS: The median follow-up duration was 57 months (13-129 months). Improvement or complete resolution on CT scans, with no symptom recurrence, was seen in 27 patients. The non-invasive approach failed in three cases and two patients underwent further intervention. No patient died during the follow-up. CONCLUSIONS: Weighing the risks versus benefits of antithrombotics and considering the benign nature of SISMAD, conservative treatment without antithrombotics might be sufficient in patients without evidence of bowel ischaemia or infarction on initial CT scan. SN - 1532-2165 UR - https://www.unboundmedicine.com/medline/citation/29229279/Outcomes_of_Spontaneous_Isolated_Superior_Mesenteric_Artery_Dissection_Without_Antithrombotic_Use_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1078-5884(17)30669-X DB - PRIME DP - Unbound Medicine ER -