Clinical course and angiographic changes of spontaneous isolated superior mesenteric artery dissection after conservative treatment

Abstract

SISMAD represented variable angiographic changes, and its clinical course was benign in this study. For patients with SISMAD, if there is no evidence of bowel infarction, bleeding or aneurysmal changes, conservative treatment with close follow-up is sufficient and could reduce unnecessary endovascular interventions.

Correlation Between Computed Tomography Features and Clinical Presentation and Management of Isolated Superior Mesenteric Artery Dissection

“…Although Sakamoto's classification and Yun's classification are widely used, neither classification has been shown to correlate with the clinical course. 1,8,9,12 Sakamoto's classification was employed in this series because it was found that most instances of true lumen stenosis were induced by compression by the false lumen. Type IV lesions according to Yun's classification were not so common in this series.…”

Value of Multi-detector CT in Detection of Isolated Spontaneous Superior Mesenteric Artery Dissection

“…The collateral vessels from the celiac trunk, inferior mesenteric artery, and marginal artery and arch of Riolan, as well as mesenteric ischemia have been demonstrated on CTA images. 17 The optimal treatment for ISSMAD has not been established. At present, the main option includes conservative, endovascular intervention and surgical treatment.…”

Spontaneous Isolated Superior Mesenteric Artery Dissection

“…Treatment approaches include conservative management with anticoagulation and blood pressure control, percutaneous endovascular interventions such as stent placements [7], intralesional thrombolytic therapy or embolotherapy, and surgical interventions such as artery ligation, endoaneurysmorraphy, aortomesenteric bypass, or laparotomic resection. A treatment algorithm has been suggested by some authors [9, 10, 13, 14].…”

“…A true isolated SMA dissection is a rare occurrence. This was first described in 1947 by Bauersfeld [2], but few cases have been reported in the literature since then [3, 4, 5, 6, 7, 8, 9, 10]. However, the increasing use of diagnostic imaging studies in the management of patients with acute abdominal pain has resulted in this rare disease having receied more attention recently.…”