scholarly journals A Case of Superior Mesenteric Artery Dissection with Retrograde Blood Flow in the False Lumen Observed by Duplex Ultrasonography

2020 ◽  
Vol 60 (6) ◽  
pp. 79-81
Author(s):  
Yohei Kudo ◽  
Yutaka Watanabe ◽  
Hidenori Tamegai ◽  
Takeki Suzuki ◽  
Takehiko Ooishi ◽  
...  
2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Hidenori Yamaguchi ◽  
Satoru Murata ◽  
Tatsuo Ueda ◽  
Takahiko Mine ◽  
Shiro Onozawa ◽  
...  

Abstract Background Spontaneous isolated visceral artery dissection is rarely encountered. Endovascular intervention with good outcomes has become popular for patients with persistent symptoms or developing ischemia. We could perform life-saving treatment for a spontaneous isolated superior mesenteric artery dissection with a unique endovascular intervention. Case presentation We describe the case of an 80-year-old man who presented with acute abdominal pain and a spontaneous isolated superior mesenteric artery dissection measuring 35 mm in major diameter and 6.6 mm in minor diameter on abdominal contrast-enhanced computed tomography. After admission, abdominal pain was progressive, and a repeated scan revealed progression of the dissection. As an endovascular intervention, via the bilateral femoral approach, detachable coils were placed in the false lumen of the superior mesenteric artery dissection through the false lumen under the micro-balloon occlusion at the point of re-entry and entry through the true lumen to prevent coil migration. Technical and clinical success was achieved without serious adverse events. Conclusion Coil embolization using micro-balloon assistance combined with the double-catheter technique for a large entry and re-entry false lumen of a spontaneous isolated superior mesenteric artery dissection was useful and feasible.


Vascular ◽  
2013 ◽  
Vol 22 (5) ◽  
pp. 350-355 ◽  
Author(s):  
Yuan Sun ◽  
Zhaolei Chen ◽  
Xicheng Zhang

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.


2017 ◽  
Vol 51 (8) ◽  
pp. 538-544 ◽  
Author(s):  
Toshihisa Ichiba ◽  
Masahiko Hara ◽  
Keiji Yunoki ◽  
Masaki Urashima ◽  
Hiroshi Naitou

Objective: There is no detailed information available about trend in the morphological change after conservative medical treatment in patients with symptomatic spontaneous isolated superior mesenteric artery dissection (SISMAD). Methods: We enrolled 27 consecutive patients with symptomatic SISMAD who underwent conservative medical treatment between 2006 and 2015. The long-term prognosis, natural history, and serial follow-up computed tomography (CT) findings of risk factors of rupture such as arterial diameter and false lumen enhancement were retrospectively assessed. Results: Spontaneous isolated superior mesenteric artery dissection usually developed in middle-aged men around 50 years old who had a history of smoking. Follow-up CT was performed at 1 to 6 months, 7 to 12 months, and after 12 months. Superior mesenteric artery (SMA) maximum diameter was 10.3 mm (quartile 9.5-11.3) on initial CT and expanded in 47.1% patients during 1- to 6-month follow-up, which decreased over time ( P < .001 at 7- to 12-month follow-up, P = .001 after 12-month follow-up). On the other hand, false lumen enhancements were revealed in 9 (33.3%) patients on initial CT. The size of false lumen enhancement was expanded in the longest diameter in 35.3% patients and in shortest diameter in 29.4% during 1- to 6-month follow-up. However, the size of false lumen decreased in all patients after 12-month follow-up. All patients were alive without arterial aneurysm rupture and hospital readmission during the median of 523 days (170-799) study period. Conclusion: We demonstrated that both SMA maximum diameter and false lumen enhancement were transiently expanded in some patients during 6-month follow-up, but no longer expanded after 12-month follow-up. Patients with symptomatic SISMAD could be treated medically with scheduled careful follow-up CT evaluations.


2021 ◽  
Author(s):  
HIDENORI YAMAGUCHI ◽  
Satoru Murata ◽  
Tatsuo Ueda ◽  
Takahiko Mine ◽  
Shiro Onozawa ◽  
...  

Abstract Background: Spontaneous isolated visceral artery dissection is rarely encountered. Endovascular intervention with good outcomes has become popular for patients with persistent symptoms or developing ischemia. We could perform life-saving treatment for a spontaneous isolated superior mesenteric artery dissection with a unique endovascular intervention.Case presentation: We describe the case of an 80-year-old man who presented with acute abdominal pain and a spontaneous isolated superior mesenteric artery dissection measuring 35 mm in major diameter and 6.6 mm in minor diameter on abdominal contrast-enhanced computed tomography. After admission, abdominal pain was progressive, and a repeated scan revealed progression of the dissection. As an endovascular intervention, via the bilateral femoral approach, detachable coils were placed in the false lumen of the superior mesenteric artery dissection through the false lumen under the micro-balloon occlusion at the point of re-entry and entry through the true lumen to prevent coil migration. Technical and clinical success was achieved without serious adverse events.Conclusion: Coil embolization using micro-balloon assistance combined with the double-catheter technique for a large entry and re-entry false lumen of a spontaneous isolated superior mesenteric artery dissection was useful and feasible.


2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Shinichi Tanaka ◽  
Atsushi Fukuda ◽  
Eisuke Kawakubo ◽  
Takuya Matsumoto

Abstract Background Most patients with isolated superior mesenteric artery (SMA) dissection are successfully managed conservatively. However, some patients require more invasive treatment. Case presentation We herein describe a 45-year-old man with isolated SMA dissection. He initially underwent conservative treatment. However, because of persistent abdominal angina, we considered the need for surgical revascularization. He was successfully treated by endarterectomy, patch angioplasty, and retrograde open mesenteric stenting. The abdominal angina was stabilized thereafter. Conclusions The combination of endarterectomy, patch angioplasty, and retrograde open mesenteric stenting is useful for isolated SMA dissection, and long patency can be expected for some patients.


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