Current Treatment Strategy for Spontaneous Isolated Dissection of the Superior Mesenteric Artery

Ogino, Hitoshi

doi:10.1253/circj.cj-16-0406

Cited by 14 publications

(13 citation statements)

References 16 publications

(16 reference statements)

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“…1 Various treatment options have been used to manage IMAD aneurysm, including conservative management, endovascular stenting, and surgical treatment. 5 Although most cases of IMAD can be managed successfully with conservative therapy according to European Society for Vascular Surgery (ESVS) guidelines, approximately 20% of patients ultimately need y These authors contributed equally to this work.…”

Section: Introductionmentioning

confidence: 99%

Endovascular Treatment of Patients with Isolated Mesenteric Artery Dissection Aneurysm: Bare Stents Alone Versus Stent Assisted Coiling

Jia

Chen

et al. 2019

European Journal of Vascular and Endovascular Surgery

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WHAT THIS PAPER ADDS Endovascular stenting has been used successfully in the management of symptomatic isolated mesenteric artery dissection (IMAD) aneurysms. However, no study has compared the use of bare stents alone versus stent assisted coiling in IMAD aneurysms. The results of this study indicate that bare stents alone and stent assisted coiling have high technical success rates and demonstrate good mid-term patency in patients with IMAD aneurysms. Bare stents alone may serve as an alternative to stent assisted coiling for the management of IMAD aneurysms. Objective: The aim was to evaluate the outcomes of endovascular treatment with bare stents alone versus stent assisted coiling in isolated mesenteric artery dissection (IMAD) aneurysms. Methods: Patients with an IMAD aneurysm who underwent endovascular stenting between February 2010 and February 2017 at one of three institutions were included in this study. Data regarding technical success, procedure time, symptom resolution, complications, changes in IMAD aneurysm, and stent patency were recorded. Results: A total of 38 patients (35 men) were included, 27 treated with bare stents alone and 11 treated with stent assisted coiling. Technical success was achieved in 100% of patients treated with bare stents and in 81.8% of those treated with stent assisted coiling (p ¼ 0.078). The mean procedure times were 62.6 AE 5.3 min for treatment with bare stents and 116.4 AE 8.4 min for stent assisted coiling (p < 0.001). A total of 23 patients had persistent symptoms before stenting; all symptoms were resolved within 3.0 AE 0.7 days. No procedure related major complications occurred. Over 30.2 AE 18.1 months of follow up, complete resolution of the IMAD aneurysm was achieved in all patients; good stent patency and in stent re-stenosis were achieved in 65.8% and 34.2% patients, respectively. There were no occlusions of the stented arteries. Conclusions: Bare stents alone and stent assisted coiling have high technical success rates and demonstrate good intermediate patency in patients with an IMAD aneurysm. Bare stents alone may serve as an alternative to stent assisted coiling for the management of IMAD aneurysm

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Section: Introductionmentioning

confidence: 99%

Endovascular Treatment of Patients with Isolated Mesenteric Artery Dissection Aneurysm: Bare Stents Alone Versus Stent Assisted Coiling

Jia

Chen

et al. 2019

European Journal of Vascular and Endovascular Surgery

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“…Acute mesenteric ischemia (AMI) due to superior mesenteric artery (SMA) dissection (SMAD) or SMA thrombosis (SMAT) impairs blood supply to the intestine and can cause acute intestinal ischemia, which may lead to intestinal necrosis [1][2][3]. Because intestinal ischemia and necrosis are associated with a high mortality rate, delay in the diagnosis of intestinal ischemia or necrosis should be avoided as much as possible [4,5].…”

Section: Introductionmentioning

confidence: 99%

Baseline disease is a more important predictor of intestinal necrosis than CT findings in patients with acute mesenteric ischemia

Ichiba¹,

Hara

Yunoki³

et al. 2016

The American Journal of Emergency Medicine

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“…Although several treatment options, including conservative, endovascular, and surgical treatment, are available, there is currently no consensus regarding the optimal management of SISMAD. 1) 6) 13 14 15 16) …”

Section: Management Strategymentioning

confidence: 99%

“…Multiple algorithms for treatment have been published, but none include all aspects of pathology and treatment. 2) 6) 19) 20) 21) 22) 23) 24) 25) 26) 27) 28) 29) 30) Our suggested treatment algorithm for SISMAD is outlined in Fig. 7…”

Section: Management Algorithm Of Sismadmentioning

confidence: 99%

“…Although significant advances in the understanding, diagnosis, and management of SISMAD have been made since the first reported case in 1947, 5) no consensus has emerged regarding which classification and management strategy should be used. 6) This study aims to review current SISMAD classification and management strategies to identify the optimal classification and management strategy for SISMAD.…”

Section: Introductionmentioning

confidence: 99%

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The Classification and Management Strategy of Spontaneous Isolated Superior Mesenteric Artery Dissection

Jia

Jiang

2017

Korean Circ J

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Spontaneous isolated superior mesenteric artery dissection (SISMAD) is an uncommon but potentially catastrophic pathology. Multiple classification schemes have been proposed for this occurrence. Although no consensus has emerged regarding which classification should be used, Li's classification scheme is more precise and complete compared to other classification systems and can be used to guide the treatment of SISMAD. Initial conservative treatment is promising, with favorable early and long-term outcomes for most patients; endovascular treatment is recommended for patients with persistent/recurrent symptoms after conservative treatment; surgical treatment should be performed without delay for patients with arterial rupture, intestinal necrosis, or failed endovascular treatment.

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Current Treatment Strategy for Spontaneous Isolated Dissection of the Superior Mesenteric Artery

Cited by 14 publications

References 16 publications

Endovascular Treatment of Patients with Isolated Mesenteric Artery Dissection Aneurysm: Bare Stents Alone Versus Stent Assisted Coiling

Endovascular Treatment of Patients with Isolated Mesenteric Artery Dissection Aneurysm: Bare Stents Alone Versus Stent Assisted Coiling

Baseline disease is a more important predictor of intestinal necrosis than CT findings in patients with acute mesenteric ischemia

The Classification and Management Strategy of Spontaneous Isolated Superior Mesenteric Artery Dissection

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