Management of spontaneous isolated intramural hematoma of the superior mesenteric artery: a single-center experience

Abstract Background: Spontaneous isolated superior mesenteric artery dissection (SISMAD) is a rare vascular disorder, and the treatment strategies remain controversial. This study aimed to compare outcomes of conservative and endovascular treatments in symptomatic patients with SISMAD. Methods: Forty-two consecutive SISMAD patients who were admitted to a single center between October 2009 and May 2018 were enrolled in this study. Based on their symptoms, 15 had conservative treatment, and 27 had endovascular treatment. The baseline characteristics, treatments, and follow-up results of the conservative group and endovascular group were analysed. Results: The rates of symptom relief were 93.3% in the conservative group and 96.3% in the endovascular group. The procedure-related complications in the endovascular group included one case of pseudoaneurysm formation in the left brachial artery. During the follow-up period (median 28.5 months), a higher proportion of patients in the conservative group had symptom recurrence (42.9% in the conservative group versus 4.8% in the endovascular group, p < 0.001). Four patients in the conservative group and one patient in the endovascular group had additional endovascular intervention during follow-up. Compared with the conservative group, patients in the endovascular group had statistically significantly longer symptom-free survival ( p = 0.014) and a higher rate of superior mesenteric artery (SMA) remodeling ( p < 0.001). Conclusions: For symptomatic SISMAD, endovascularly treated patients had a lower rate of symptom recurrence and a higher rate of SMA remodeling in the long term. Prospective, multi-center studies are needed to confirm the long-term outcomes of both treatments.

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Long-term Outcomes of Conservative Treatment and Endovascular Treatment in Patients with Symptomatic Spontaneous Isolated Superior Mesenteric Artery Dissection: A Single-center Experience

10.21203/rs.2.17427/v1 ◽

2019 ◽

Author(s):

Leyin Xu ◽

Daming Zhang ◽

Chenyang Qiu ◽

Jingjing Wang ◽

Kang Li ◽

...

Keyword(s):

Endovascular Treatment ◽

Superior Mesenteric Artery ◽

Mesenteric Artery ◽

Artery Dissection ◽

Single Center ◽

Conservative Group ◽

Superior Mesenteric Artery Dissection ◽

Symptom Recurrence

Abstract Background: Spontaneous isolated superior mesenteric artery dissection (SISMAD) is a rare vascular disorder and the treatment strategies remain controversial. This study aimed to compare outcomes of conservative and endovascular treatments in symptomatic patients with SISMAD. Methods: Forty-two consecutive SISMAD patients between October 2009 and May 2018 in a single center were enrolled in the study. Based on their symptoms, 15 had conservative treatment and 27 had endovascular treatment. The baseline characteristics, treatments, and follow-up results of the conservative group and endovascular group were analyzed. Results: The rate of symptom relief was 93.3% in the conservative group and 96.3% in the endovascular group, respectively. The procedure-related complications in the endovascular group included one case of pseudoaneurysm formation in the left brachial artery. During the follow-up period (median 28.5 months), a higher proportion of patients in the conservative group had symptom recurrence (42.9% in the conservative group versus 4.8% in the endovascular group, p < 0.001). Four patients in the conservative group and one patient in the endovascular group had additional endovascular intervention during follow-up. Compared with the conservative group, patients in the endovascular group had statistically significantly longer symptom-free survival ( p = 0.014) and a higher rate of superior mesenteric artery (SMA) remodeling ( p < 0.001). Conclusions: For symptomatic SISMAD, endovascularly treated patients had a lower rate of symptom recurrence and a higher rate of SMA remodeling in the long term. Endovascular treatment should be considered as the first-line treatment of SISMAD.

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The Management of Superior Mesenteric Artery Aneurysm: Experience with 16 Cases in a Single Center

Annals of Vascular Surgery ◽

10.1016/j.avsg.2016.11.014 ◽

2017 ◽

Vol 42 ◽

pp. 120-127 ◽

Cited By ~ 8

Author(s):

Li Zilun ◽

Yin Henghui ◽

Zhao Yang ◽

Wang Mian ◽

Chang Guangqi ◽

...

Keyword(s):

Superior Mesenteric Artery ◽

Mesenteric Artery ◽

Artery Aneurysm ◽

Single Center

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Does the degree of calcification of the celiac trunk and superior mesenteric artery on preoperative computerized tomography predict the risk of anastomotic leak after right colectomy? A single center retrospective study

Journal of Visceral Surgery ◽

10.1016/j.jviscsurg.2018.10.006 ◽

2019 ◽

Vol 156 (3) ◽

pp. 191-195 ◽

Cited By ~ 3

Author(s):

B. Postaire ◽

E. Abet ◽

P. Montigny ◽

P.A. Vent

Keyword(s):

Retrospective Study ◽

Superior Mesenteric Artery ◽

Anastomotic Leak ◽

Computerized Tomography ◽

Mesenteric Artery ◽

Celiac Trunk ◽

Right Colectomy ◽

Single Center

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Management of Pancreaticoduodenal Artery Aneurysms Based on a Single-Institution Experience

Vascular and Endovascular Surgery ◽

10.1177/15385744211017112 ◽

2021 ◽

pp. 153857442110171

Author(s):

Kunal Vani ◽

Keith D. Calligaro ◽

Krystal Maloni ◽

Nicholas Madden ◽

Douglas A. Troutman ◽

...

Keyword(s):

Hepatic Artery ◽

Endovascular Therapy ◽

Mesenteric Artery ◽

Celiac Artery ◽

Surgical Reconstruction ◽

Single Center ◽

Single Institution ◽

Pancreaticoduodenal Artery ◽

Single Center Experience ◽

High Propensity

Objectives: Pancreaticoduodenal artery aneurysms (PDAAs) are rare and have a high propensity for rupture. Historically, management of PDAAs included surgical reconstruction but has evolved with advances in endovascular therapy. We report our experience with management of PDAAs during the last 30 years. Methods: We retrospectively reviewed our prospectively maintained registry between January 1, 1992 – March 30, 2020. Results: We identified 8 patients with PDAAs: 4 with associated celiac artery occlusive disease and 4 without identifiable etiologies. Four patients were treated with surgical resection of the PDAAs: 2 intact aneurysms underwent concomitant revascularization (superior mesenteric artery-to-hepatic artery Dacron bypass; supra celiac aorta-to-hepatic artery Dacron bypass) and 2 (1 intact, 1 rupture) underwent ligation alone. Four patients were treated with coil embolization of the PDAA: 2 with concomitant stent-graft exclusion of the aneurysm (1 non-rupture, 1 rupture) and 2 without adjunctive measures (intact). There were no deaths nor any significant procedure-related morbidity. Conclusion: Our large single-center experience shows that PDAAs can be successfully treated by open or endovascular intervention with selective revascularization.

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