Endovascular Treatment of a Splenic Aneurysm Associated With Segmental Arterial Mediolysis

Khan, Adam; Freeman, Anthony; Patapanian, H.

doi:10.1016/j.ejvssr.2017.06.001

Cited by 2 publications

(7 citation statements)

References 11 publications

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“…Reported methods for diagnosing SAM. (A) A total of 121 cases were identified from the 66 case reports 4,5,8–10,13,22–81 with unique diagnostic strategies. For publications detailing multiple patients, a case was counted as unique if the diagnostic strategy was specifically based on that patient’s presentation and was considered redundant and only recorded once if the same strategy was applied to multiple patients in the report.…”

Section: Discussionmentioning

confidence: 99%

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Segmental arterial mediolysis (SAM): Systematic review and analysis of 143 cases

et al. 2019

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Segmental arterial mediolysis (SAM) is a rare but serious nonatherosclerotic, noninflammatory vasculopathy of unknown etiology that often results in dissection, aneurysm, occlusion, or stenosis of, primarily, the abdominal arteries. Current literature lacks consensus on diagnostic criteria and management options for SAM. This review summarizes 143 cases and aims to advance appropriate recognition and management of SAM. Literature review of all relevant SAM case studies from 2005 to 2018 yielded 126 individual SAM cases from 66 reports. We identified 17 additional SAM cases from our center, bringing our analysis to 143 patients. Patients with SAM were most commonly men (68%) in their 60s. Hypertension (43%), tobacco use (12%), and hyperlipidemia (12%) were common comorbidities. Abdominal pain (80%) and intraabdominal bleeding (50%) were the most common presenting symptoms. Computed tomography was the most frequently used imaging method (78%), and histology was available in 44% of cases. The most commonly affected vessels were the superior mesenteric (53%), hepatic (45%), celiac (36%), renal (26%), and splenic (25%) arteries with aneurysm (76%), dissection (61%), and arterial rupture (46%). Treatments included coil embolization (28%), abdominal organ surgery (24%), open arterial repair (21%), and medical management (20%). Case-specific treatment modalities yielded symptom relief in the vast majority (91%) of patients, with a mortality rate of 7%.

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Section: Discussionmentioning

confidence: 99%

“…A total of 126 unique cases were identified from 66 different case reports and case studies (Supplementary Table 1). 4,5,8–10,13,22–81…”

Section: Methodsmentioning

confidence: 99%

Segmental arterial mediolysis (SAM): Systematic review and analysis of 143 cases

et al. 2019

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“…The radiologic feature of SAM is defined as a string-of-beads appearance or the presence of multiple fusiform aneurysms. 3,4 Angiography of the patient showed irregular vasodilated lesions in the LGA and left and right GEAs, which were interpretable as string-of-beads appearance or multiple fusiform aneurysms. Additionally, it showed slight abnormalities on SGA and pancreatic duodenal arteries, and no abnormalities on hepatic and splenic arteries.…”

Section: Discussionmentioning

confidence: 96%

“…6 Due to improvements in technology and expertise, intervention radiology (IR) for ruptured aneurysms has recently become the preferred management method for patients with SAM and intraabdominal hemorrhage. [2][3][4]6 Surgery is selected for cases with severe shock or organ ischemia or when the rupture cannot be controlled by IR.…”

Section: Discussionmentioning

confidence: 99%

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Segmental arterial mediolysis with a ruptured visceral artery on two consecutive days

Ito,

Koyama,

Fujimori

et al. 2023

Acute Medicine & Surgery

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BackgroundWe describe a case of segmental arterial mediolysis in which a vessel ruptured on two consecutive days.Case PresentationA 69‐year‐old man presented with sudden‐onset abdominal pain. Computed tomography showed a hematoma in the gastric wall. The patient was discharged after the pain was relieved but returned 8 h later with abdominal pain and shock. Repeated computed tomography revealed a massive intra‐abdominal hemorrhage without previous aneurysm formation. Emergency angiography and coil embolization were successfully carried out. Segmental arterial mediolysis was diagnosed after irregular vasodilated lesions were observed in multiple arteries.ConclusionThis case suggests that accurately predicting the next vessel rupture is difficult. For patients experiencing intra‐abdominal bleeding with segmental arterial mediolysis, we suggest treating only ruptured aneurysms and closely following‐up unruptured aneurysms.

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Endovascular Treatment of a Splenic Aneurysm Associated With Segmental Arterial Mediolysis

Cited by 2 publications

References 11 publications

Segmental arterial mediolysis (SAM): Systematic review and analysis of 143 cases

Segmental arterial mediolysis (SAM): Systematic review and analysis of 143 cases

Segmental arterial mediolysis with a ruptured visceral artery on two consecutive days

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