Background: In recent years, endovascular treatment of subclavian artery pseudoaneurysm (SAP) has been recommended by many experts. The aim of this study is to evaluate the safety and efficacy of the endovascular treatment of SAP, and to introduce our experience in the diagnosis and treatment of SAP. Methods: A total of 8 consecutive patients with SAP were treated with endovascular treatment in our hospital between 2010 and 2018. We retrospectively reviewed the patients' clinical characteristics, physical examinations findings, diagnostic imaging results, endovascular treatment, clinical outcome, and follow-up results. Results: All the 8 patients received endovascular treatment with covered stents initially. The technical success rate was 87.5% (7/8). In 1 patient with severe tortuosity of the proximal subclavian artery, the stent could not be released through the femoral artery approach in the primary operation but was successfully released via the brachial artery approach in the secondary operation. No complications occurred in the perioperative period. All the symptoms and signs were significantly relieved. During a follow-up of 4.5e84.5 months (average 31.5 months), 1 patient developed an endoleak 4 months after operation and reintervention was attempted but failed. No adverse events occurred in other patients during the follow-up period. Conclusions: Endovascular treatment of SAP is safe and effective, and should be used as a first-line treatment. Stent placement through the brachial artery approach is recommended for SAP with severe proximal vascular tortuosity.

Background: Isolated dissection of visceral artery organs is very infrequently reported and when occurred mostly affected is the superior mesenteric artery (SMA) with abdominal pain as the commonest presenting features in symptomatic patients. Dissection can be detected by ultrasound and CT, but computed tomography angiography (CTA) is the best for demonstration of the true and false lumens of the lesion. Nonetheless, the perfect treatment has not been accepted yet. However, if left untreated, it is a lifethreatening condition. Objectives: Our aim is to evaluate diagnostic imaging and endovascular treatment outcome of spontaneous isolated superior mesenteric artery dissection (SISMAD). Based on the angiographic configuration of SMA and location of dissection we will share our experience based on deployment of a bare straight stent, bare tapered stent, overlapping bare stent or coil assisting bare stent. Patients and Methods: Medical data from patients presented with symptomatic superior mesenteric artery dissection (SMAD) and had received endovascular treatment between January 2007 and December 2017 were extracted. Patient demographics, symptoms, diagnostic imaging, endovascular treatment, and follow-up findings were analyzed.Results: Total of 31 patients were included in this study [87.1% (n = 27) male, 12.9% (n = 4) female, and mean age 52.9 ± 8.2 years]. All patients had abdominal pain as the main presenting symptom. The mean length of dissection was (4.79 ± 3.03) cm, mean distance from the aorta to dissection entry was 2.5 ± 1.0cm, mean percentage stenosis was 63.3 ± 12.7%, Sakamoto type IIA was seen in 35.5%(n = 11), and type IIB in 64.5% (n = 20). All of the patients received bare self-expandable stent whereby 90.3% (n = 28) received stent(s) without coil, of which 64.3% (n = 18) received single straight stent, 21.4% (n = 6) received overlapping stent and 14.3% (n = 4) received tapered stent. On the other hand, 9.7% (n = 3) received coil assisting stent. Post-procedure normal blood supply to the distal SMA and relief of symptoms was noted. One hundred percent (n = 31) primary success rate was recorded during mean fasting and follow-up time of 4.9 ± 1.9 days and 15.5 ± 4.8 months, respectively. Conclusion:Endovascular treatment with a bare stent is a safe, effective, and successful treatment for symptomatic SISMAD with satisfactory outcomes. We highly recommend it to be considered as a first-line treatment in severe co-morbidity patients who are unfit for open surgery.

Introduction Isolated dissection of visceral artery organs is very infrequently reported and when it occurs it mostly affects the superior mesenteric artery (SMA) with abdominal pain as the commonest presenting symptom. However, the best therapeutic strategy in symptomatic patients has not yet been established. Aim To evaluate the safety and efficacy of conservative, endovascular bare stent and endovascular coil assisting bare stent treatments for patients diagnosed with spontaneous isolated superior mesenteric artery dissection (SISMAD). Material and methods We reviewed patients who had SISMAD and received conservative, bare stent and coil assisting bare stent as a primary treatment between 2014 and 2018. Patient demographics, symptoms, angiographic findings and treatment outcomes were analyzed. Results A total of 62 patients was found to have SISMAD among whom 83.9% (n = 52) were male and 16% (n = 10) were female with the mean age of 52.55 ±7.22 years, range 33–77. 22.6% (n = 14) received conservative, 62.9% (n = 39) endovascular bare stent and 14. Four percent (n = 9) endovascular coil assisting bare stent treatment. The success rate in primary treatment was conservative 78.5% (n = 11), bare stent 97.4% (n = 38), coil assisting bare stent 100% (n = 9). The mean follow-up duration (months) was 28.76 ±12.87. Conclusions Endovascular bare stent placement is a safe, effective, and successful treatment in the management of symptomatic SISMAD. The diagnostic imaging result is a key point for planning appropriate treatment especially in patients with tapered vessels, longer dissection lesion, and dissection aneurysm where coil assisting bare stent shows good results. Conservative treatment should be given priority for the asymptomatic patient, but close monitoring is highly recommended.