Spontaneous splanchnic dissection: Application and timing of therapeutic options

Abstract

Successful outcomes following SSD may be achieved with either non-operative therapy alone or intervention if persistent symptoms, expansion of false lumen, and/or malperfusion occur. The unpredictable response of the false lumen to conservative management mandates close, long-term follow-up. Endovascular and operative interventions produced similar outcomes in a small number of patients with limited follow-up. Although SSD is currently perceived as rare, the increasing use of CTA may prove that the true incidence has been underestimated.

Successful percutaneous embolization of a symptomatic celiac artery dissection with aneurysmal dilation with detachable vascular plugs

“…3 SDs of the celiac artery are the least common of all splanchnic artery dissections. 1,2 From 1975 to 2008, 74 SDs of the SMA were described 1 vs only 31 SDs of the celiac artery. In a review of the literature, 40 cases of SDs of the celiac artery (including 31 cases of Takach 1 ) were described.…”

“…2,8,13,14 In contrast, complicated dissection with persistent pain, expansion of a false lumen, or aneurysmal dilation and rupture, as in our report, warrant immediate operative 1,6 or endovascular intervention. 1,5 Endovascular techniques are currently considered the method of choice for first-line treatment of CAAs of Ն2 cm in diameter to prevent rupture. 1,[17][18][19][20] In the literature, the 2-cm threshold appears quite arbitrary.…”

“…1,5 Endovascular techniques are currently considered the method of choice for first-line treatment of CAAs of Ն2 cm in diameter to prevent rupture. 1,[17][18][19][20] In the literature, the 2-cm threshold appears quite arbitrary. However, in the Mayo Clinic series of 18 CAAs, ruptures occurred in 2 patients, both of whom had CAAs Ͼ2 cm.…”

“…It is only rarely seen with the celiac artery. 1,2 The etiology and natural history of these lesions are ill-defined, and treatment options remain a subject of debate. This case report describes a celiac artery dissection with associated aneurysmal dilation, revealed by intra-abdominal hemorrhage, which was successfully managed by endovascular intervention.…”

Dissecção espontânea do tronco celíaco: qual a melhor abordagem terapêutica?

“…Spontaneous dissection of visceral arteries (SDVA) is a rare condition of the upper mesenteric artery, but it may also affect the celiac trunk, splenic artery and lower mesenteric artery [1][2][3][4] . Risk factors include atherosclerotic disease, hypertension, fribromuscular dysplasia, and stress, among others [5][6][7][8][9][10] .…”