scholarly journals Endovascular stent placement for isolated superior mesenteric artery dissection with intestinal ischaemia

VASA ◽  
2019 ◽  
Vol 48 (1) ◽  
pp. 73-78 ◽  
Author(s):  
Baochen Liu ◽  
Chengnan Chu ◽  
Xinxin Fan ◽  
Weiwei Ding ◽  
Xingjiang Wu
Keyword(s):  
Conservative Treatment ◽  
Stent Placement ◽  
Mesenteric Artery ◽  
Intestinal Resection ◽  
Artery Dissection ◽  
Intestinal Ischaemia ◽  
Endovascular Stent ◽  
Endovascular Stent Placement ◽  
Resection And Anastomosis ◽  
Superior Mesenteric Artery Dissection

Abstract. Background: Isolated superior mesenteric artery dissection (ISMAD) is rare, especially when associated with intestinal ischaemia. We report our clinical experience managing this condition. Patients and methods: Medical records from 22 patients with ISMAD and intestinal ischaemia were retrospectively analysed. Conservative treatment was given to all patients as first line therapy. Subsequently, 15 patients received endovascular stent placement and three patients received endovascular stent placement plus intestinal resection and anastomosis. Results: After conservative treatment, the symptoms of three patients were remarkably relieved; however, a repeat contrast CT showed that stenosis was aggravated. Hence, endovascular stent placement was performed in all 15 patients. Enteral nutrition was successfully restored in 12 patients. Three patients showed signs of chronic intestinal ischaemia, including peritonitis and ileus. These patients underwent intestinal resection and anastomosis. Enteral nutrition was restored at postoperative week two. No signs of intestinal ischaemia recurred during two-years of follow-up. Conclusions: We recommend endovascular stent placement as a feasible, effective, and minimally invasive procedure in patients with ISMAD and symptoms of intestinal ischaemia.

Application of endovascular stent placement as a remedy for spontaneous isolated superior mesenteric artery dissection

Vascular ◽  
2013 ◽  
Vol 22 (5) ◽  
pp. 350-355 ◽  
Author(s):  
Yuan Sun ◽  
Zhaolei Chen ◽  
Xicheng Zhang
Keyword(s):  
Superior Mesenteric Artery ◽  
Stent Placement ◽  
Mesenteric Artery ◽  
False Lumen ◽  
Artery Dissection ◽  
Endovascular Stent ◽  
Safe Alternative ◽  
Period Range ◽  
Endovascular Stent Placement ◽  
Superior Mesenteric Artery Dissection

Objectives To present our experience regarding endovascular stent placement for the treatment of spontaneous isolated superior mesenteric artery dissection (SISMAD) and to evaluate the safety and feasibility of the endovascular therapy. Methods The clinical data from six patients with SISMAD who underwent endovascular stent placement in two institutions from March 2010 to May 2012 were analyzed retrospectively. Four patients were implanted a self-expanding stent, and an additional stent was deployed in two of these patients after the first stent was implanted. One patient was subjected to a self-expanding stent implantation combined with coil embolization. The remaining patient underwent thrombectomy plus partial intimectomy 2 months before a balloon-expandable stent was implanted. Results All of the patients recuperated uneventfully without any reoccurrence of the symptoms in the follow-up period (range 12–38 months). Contrast-enhanced computer tomography scanning was performed 3 months after the procedure in all of the patients, and the images showed that the false lumen was nearly thrombosed and that the true lumen was maintained patent. Conclusions Endovascular stent placement is a simple and safe alternative to aggressive surgery or uncertain observation.

Primary conservative treatment for peritonitis-absent symptomatic isolated dissection of the superior mesenteric artery with severely compressed true lumen

Vascular ◽  
2019 ◽  
Vol 28 (2) ◽  
pp. 132-141 ◽  
Author(s):  
Gang Fang ◽  
Genying Xu ◽  
Yuan Fang ◽  
Jue Yang ◽  
Tianyue Pan ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Medical Treatment ◽  
Stent Placement ◽  
Mesenteric Artery ◽  
Treatment Algorithm ◽  
Endovascular Stent ◽  
True Lumen ◽  
The Mean ◽  
Endovascular Stent Placement

Objectives The purpose of this study was to evaluate the safety and efficacy of primary conservative treatment (PCT) for peritonitis-absent symptomatic spontaneous isolated dissection of the superior mesenteric artery (S-SIDSMA) with severely compressed true lumen. Methods From January 2013 to December 2018, PCT was used in 26 cases of peritonitis-absent S-SIDSMA with severely compressed true lumen in our center based on our previous proposed treatment algorithm for S-SIDSMA. The demographics, duration from the onset to the admission, duration from the start of the conservative treatment to the alleviation of the symptoms, and in-hospital and follow-up clinical and angiographic outcomes were prospectively recorded and then analyzed. Results Among the 26 included patients, 84.6% were male. The mean age of the patients was 54.7 years. The mean duration from the onset to the admission was 3.1 days (range, 1–14 days). Symptoms in 22 patients were markedly or completely relieved during the first five-day medical treatment. Endovascular stent placement was attempted in the remaining four patients, which was successfully performed in three (75%) of them. The technical failure occurred in a patient whose compressed true lumen failed to be cannulated. Medical treatment was then continued in this patient, and his symptoms were relieved after a two-day medical treatment. During the mean follow-up period of 14.3 months, endovascular stent placement was performed in three patients due to the recurrence of the abdominal pain and the chronic intestinal ischemia. No patient showed dissection progression during the follow-up. The complete remodeling rate of the stent group was significantly higher than that of the medical group (83.3% vs. 25%, P = 0.021). Conclusions Based on our previous proposed treatment algorithm for S-SIDSMA, PCT could achieve satisfactory results both clinically and morphologically in peritonitis-absent S-SIDSMA with severely compressed true lumen.

Endovascular Stent Placement for Treatment of Spontaneous Isolated Dissection of the Superior Mesenteric Artery

2014 ◽  
Vol 28 (2) ◽  
pp. 445-451 ◽  
Author(s):  
Nan Li ◽  
Qing-Sheng Lu ◽  
Jian Zhou ◽  
Jun-Min Bao ◽  
Zhi-Qing Zhao ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Stent Placement ◽  
Mesenteric Artery ◽  
Endovascular Stent ◽  
Endovascular Stent Placement
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