scholarly journals Short and Long Term Outcome of the Symptomatic Isolated Superior Mesenteric Artery Dissection after Conservative Treatment

2021 ◽  
Vol 61 (5) ◽  
pp. 33-38
Author(s):  
Hirofumi Sugawara ◽  
Hitoshi Goto ◽  
Daijirou Akamatsu ◽  
Yoshitaro Yoshida ◽  
Yuta Tajima ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Artery Dissection ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Short And Long Term ◽  
Superior Mesenteric Artery Dissection

The value of a new image classification system for planning treatment and prognosis of spontaneous isolated superior mesenteric artery dissection

Vascular ◽  
2015 ◽  
Vol 23 (5) ◽  
pp. 504-512 ◽  
Author(s):  
Jiang Xiong ◽  
Zhongyin Wu ◽  
Wei Guo ◽  
Xiaoping Liu ◽  
Lijun Wang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Superior Mesenteric Artery ◽  
Computed Tomography Angiography ◽  
Mesenteric Artery ◽  
Intestinal Ischemia ◽  
Artery Dissection ◽  
Term Outcome ◽  
Superior Mesenteric Artery Dissection

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.

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

2020 ◽  
Author(s):  
Leyin Xu ◽  
Jiang Shao ◽  
Daming Zhang ◽  
Chenyang Qiu ◽  
Jingjing Wang ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Artery Dissection ◽  
Single Center ◽  
Long Term Outcomes ◽  
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 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.

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

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.

scholarly journals Long-Term Outcomes of Spontaneous Isolated Superior Mesenteric Artery Dissection

2019 ◽  
Vol 12 (4) ◽  
pp. 456-459
Author(s):  
Hirono Satokawa ◽  
Shinya Takase ◽  
Hiroki Wakamatsu ◽  
Yuki Seto ◽  
Hiroyuki Kurosawa ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Artery Dissection ◽  
Long Term Outcomes ◽  
Superior Mesenteric Artery Dissection

Treatment Strategies and Outcomes of Symptomatic Spontaneous Isolated Superior Mesenteric Artery Dissection: A Systematic Review and Meta-analysis

2018 ◽  
Vol 25 (5) ◽  
pp. 640-648 ◽  
Author(s):  
Yating Zhu ◽  
Yanghong Peng ◽  
Mingyue Xu ◽  
Yingqi Wei ◽  
Shanshan Wu ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Superior Mesenteric Artery ◽  
Success Rate ◽  
Antithrombotic Therapy ◽  
Mesenteric Artery ◽  
Meta Analysis ◽  
Case Series ◽  
Treatment Modalities ◽  
Artery Dissection ◽  
Superior Mesenteric Artery Dissection

Purpose: To analyze the published treatment experience with symptomatic spontaneous isolated superior mesenteric artery dissection (SISMAD). Methods: A literature search of the PubMed and Cochrane databases was conducted for articles on symptomatic SISMAD published in English from January 2007 to January 2018. Case series reporting on both treatment modalities and outcomes were included, while those on traumatic or iatrogenic SMA dissection or SMA dissection accompanied by aortic or other visceral artery dissection were excluded. Overall event rates for treated symptomatic SISMAD were calculated using pooled analyses. The rate of initial conservative treatment, the success rate, the rate of conversion to intervention, and the failure rate in patients with vs without antithrombotic therapy were calculated for each study and compared using a meta-analysis of proportions. Results: The 25 articles selected encompassed 616 SISMAD cases, of which 514 were symptomatic cases eligible for the analysis. Among the latter, initial treatment consisted of conservative therapy in 447 (87.0%) patients and surgical interventions in 67 (13.0%) patients [45 (8.7%) endovascular procedures and 22 (4.3%) open surgeries]. Among conservative cases, 238 (53.2%) received antithrombotic therapy while 172 (38.5%) did not; 50 (11.2%) cases were converted to intervention [42 (84%) endovascular]. Conservative treatment was initially used in 85.2% of pooled cases with an 84.7% success rate, a 14.3% rate of conversion to intervention, and conservative treatment failure rates of 17.8% and 10.1% in patients treated with vs without antithrombotic therapy, respectively (p=0.103). Conclusion: Conservative treatment appeared safe and effective in >80% of symptomatic SISMAD cases, without apparent benefit for antithrombotic agent use. Initial or secondary intervention was more often endovascular, with favorable success rates and short-term outcomes. Large, prospective randomized trials with long-term follow-up are warranted on the treatment for symptomatic SISMAD.

scholarly journals Comparison of Primary Angioplasty and Conservative Treatment on Short- and Long-term Outcome in Octogenarian or Older Patients with Acute Myocardial Infarction.

2002 ◽  
Vol 43 (5) ◽  
pp. 463-474 ◽  
Author(s):  
Hon-Kan Yip ◽  
Chiung-Jen Wu ◽  
Hsueh-Wen Chang ◽  
Chi-Ling Hang ◽  
Chih-Yuan Fang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Conservative Treatment ◽  
Older Patients ◽  
Primary Angioplasty ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Short And Long Term

scholarly journals IF7. Clinical and Angiographic Outcomes After Conservative Treatment of Isolated Superior Mesenteric Artery Dissection

2015 ◽  
Vol 61 (6) ◽  
pp. 34S-35S
Author(s):  
Kwang-Bo Park ◽  
Seon-Hee Heo ◽  
Shin-Young Woo ◽  
Yang-Jin Park ◽  
Young-wook Kim
Keyword(s):  
Conservative Treatment ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Artery Dissection ◽  
Superior Mesenteric Artery Dissection

scholarly journals Natural history of spontaneous isolated superior mesenteric artery dissection derived from follow-up after conservative treatment

2011 ◽  
Vol 54 (6) ◽  
pp. 1727-1733 ◽  
Author(s):  
Yang Jin Park ◽  
Kwang Bo Park ◽  
Dong-Ik Kim ◽  
Young Soo Do ◽  
Duk-Kyung Kim ◽  
...  
Keyword(s):  
Natural History ◽  
Conservative Treatment ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Artery Dissection ◽  
History Of ◽  
Superior Mesenteric Artery Dissection
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