Spontaneous Dissection of Superior Mesenteric Artery: Long-Term Outcome of Stent Placement

2017 ◽  
Vol 28 (12) ◽  
pp. 1722-1726 ◽  
Author(s):  
Junghoon Kim ◽  
Chang Jin Yoon ◽  
Nakjong Seong ◽  
Hyukjoon Lee ◽  
Young-Joo Kim
Vascular ◽  
2015 ◽  
Vol 23 (5) ◽  
pp. 504-512 ◽  
Author(s):  
Jiang Xiong ◽  
Zhongyin Wu ◽  
Wei Guo ◽  
Xiaoping Liu ◽  
Lijun Wang ◽  
...  

Objective To aid diagnosis of spontaneous isolated superior mesenteric artery dissection and planning management, we investigated the role of classification of features as observed on computed tomography angiography images. Methods A retrospective study was conducted, comprising computed tomography angiography images and clinical data of 28 consecutive patients with spontaneous isolated superior mesenteric artery dissection. Based on the computed tomography angiography images, a new classification for spontaneous isolated superior mesenteric artery dissection was proposed. Patients with intestinal ischemia not relieved or worsened after 10 days of conservative treatment underwent surgery or stenting. All patients were followed up with computed tomography angiography. Results Spontaneous isolated superior mesenteric artery dissection was categorized into five types (I–V). Type III was further divided into subtypes IIIa–IIIc. Spontaneous isolated superior mesenteric artery dissection IIIa and IV typified nine (32.1%) and seven (25%) patients, respectively. Six (21.4%) patients had aortic or branch artery abnormalities and 21 (78%) showed prior intestinal ischemia. Four (14.3%) patients had intestinal ischemia and underwent surgery or stenting. Conclusions Spontaneous isolated superior mesenteric artery dissection type IIIa is more likely to occur than other types. Long-term computed tomography angiography follow-up is valuable for determining treatment strategy for spontaneous isolated superior mesenteric artery dissection. Conservative therapy with anticoagulants is recommended for five days, and surgery or stenting should be considered if symptoms of intestinal ischemia are not relieved. Stent implantation provides relatively satisfactory mid-term outcome for true lumen construction of the superior mesenteric artery.


Author(s):  
Shaili S. Shah ◽  
Shruti G. Ganvit ◽  
Kirti P. Ambani ◽  
Ashish U. Katarkar

<p class="abstract"><strong>Background:</strong> Aim and objectives were to evaluate and compare the outcomes of endoscopic dacryocystorhinostomy (DCR) with and without silicone stenting. Surgical success was assessed both subjectively and objectively.  </p><p class="abstract"><strong>Methods:</strong> A retrospective study was conducted. Total 30 patients with acquired NLD obstruction were enrolled in the study. The patients who underwent the surgery were randomly assigned into two groups: group I: with silicone stent placement, group II: without stent placement. The patients were evaluated in terms of symptoms relief (subjective assessment) and patency of neo-ostium (objective assessment).   </p><p class="abstract"><strong>Results:</strong> In our study, success rate for patients with placement of stent was 91.66% and without stenting was 77.77%. Statistical data proved that, there was no significant difference between two groups. Endoscopic DCR with stenting had good long term outcome. It maintains patency and prevents re-closer of neo-ostium. With stenting cases cause of failure was synechiae formation and in without stenting cases causes was infection, granulation formation and stoma closer. So both cases had their own merits and demerits.</p><p class="abstract"><strong>Conclusions:</strong> The endoscopic DCR is minimally invasive and simple procedure. Patient’s discomfort, synechiae, granulations are drawbacks of stenting but stents had given good long term outcome in maintaining patency of neo-ostium. Still data proved, there was no significant difference in both groups. This was due to our small sample size. Regular follow up is necessary for better post-operative outcome and prevention of further complications. So ultimately it is surgeon choice and level of expertise decides use of stent in DCR.  </p>


Circulation ◽  
1998 ◽  
Vol 98 (18) ◽  
pp. 1875-1880 ◽  
Author(s):  
Shpend Elezi ◽  
Adnan Kastrati ◽  
Franz-Josef Neumann ◽  
Martin Hadamitzky ◽  
Josef Dirschinger ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document