Evaluation of isolated abdominal visceral artery dissection with multi-scale spiral computed tomography: a retrospective case series

He, Qiaoling; Yu, Fei; Fu, Yajun; Yang, Bin; Huo, Ran; Xian, Rong; Liu, Shulan; Liang, Kali; Guang-cai, Tang

doi:10.1186/s13019-021-01428-8

Cited by 6 publications

(3 citation statements)

References 31 publications

(9 reference statements)

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“…Maintaining the long-term function of vascular access is a challenge in the management of patients undergoing hemodialysis. Early detection of vascular access dysfunction as well as timely and effective intervention are the key points to deal with renal system diseases [13].…”

Section: Discussionmentioning

confidence: 99%

MSCTA imaging analysis of autologous arteriovenous fistula dysfunction in maintenance hemodialysis patients

Wang

2024

Am J Transl Res

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Objective: To observe the multi-slice spiral CT angiography (MSCTA) imaging features of arteriovenous fistula dysfunction in patients undergoing maintenance hemodialysis and analyze the significance of the imaging examination. Methods: Altogether 90 patients with end-stage renal disease treated by maintenance hemodialysis in General Hospital of China Resources & Wisco from June 2020 to February 2023 were divided into a normal function group (n=68) and a dysfunction group (n=22) according to the function of autogenous arteriovenous fistula. The clinical data of the two groups were recorded. The MSCTA was performed in each patient, and the manifestations of arteriovenous fistula dysfunction were analyzed. Additionally, the vascular access stenosis, vascular access lumen stenosis, arteriovenous diameter, blood flow, and hemodynamic indices were tested, and the value of MSCTA in predicting arteriovenous fistula function was analyzed by Logistic regression. Results: The degree of vascular access stenosis and vascular access lumen stenosis in the normal group were less than those in the dysfunctional group (P<0.05). The arteriovenous diameter, blood flow, blood flow velocity at anastomotic vein end, dialysis adequacy (spKt/V), and von Willebrand factor (vWF) function in the normal group were larger than those in the dysfunction group, and the radial artery shear force was lower than in the dysfunction group, with statistical significance (P<0.05). Among the arteriovenous fistula dysfunction, there were 3 patients with anastomotic + outflow vein stenosis, 4 patients with outflow vein stenosis, 9 patients with inflow artery + anastomosis + outflow vein stenosis, and 6 patients with superior vena cava stenosis. Logistic regression analysis showed that slow blood flow velocity at the venous end of anastomosis and high shear force of radial artery were influencing factors of arteriovenous fistula dysfunction, and the area under ROC curve of blood flow velocity at the venous end of anastomosis plus shear force of radial artery was 0.93, with a sensitivity of 0.87 and a specificity of 0.85. Conclusion: MSCTA can be used to evaluate the dysfunction of autologous arteriovenous fistula in patients undergoing maintenance hemodialysis, and provide important reference information for the formulation of the next best clinical treatment plan.

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Section: Discussionmentioning

confidence: 99%

MSCTA imaging analysis of autologous arteriovenous fistula dysfunction in maintenance hemodialysis patients

Wang

2024

Am J Transl Res

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“…Como a dissecção de AMS é muitas vezes de difícil diagnóstico 13 e ainda não existe consenso sobre o melhor tratamento para cada caso 8,14 , os sinais clínicos e o acompanhamento do paciente são essenciais para um desfecho favorável. Quando necessário, deve ser indicada a abordagem cirúrgica mais adequada para cada caso, seja por reparo aberto, endovascular ou combinado.…”

Section: Parte Ii: Terapêuticaunclassified

Tratamento combinado na dissecção de artéria mesentérica superior: desafio terapêutico

Ficagna

Galindo²,

Mazon

et al. 2022

J. vasc. bras.

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Resumo A dissecção da artéria mesentérica superior é uma causa rara de dor abdominal, com quadro clínico variável. Seu diagnóstico é difícil, e não existe consenso sobre suas opções terapêuticas; elas variam em torno de tratamento conservador, correção aberta, endovascular ou combinada. Descrevemos o caso de um homem de 45 anos com dissecção isolada da artéria mesentérica superior, com quadro de dor abdominal persistente após tentativa de tratamento conservador. Ele foi submetido à revascularização cirúrgica aberta devido à localização e complexidade da dissecção. O tratamento com endarterectomia, arterioplastia com remendo de pericárdio bovino e acesso retrógrado para abertura da mesentérica com stent foi realizado com sucesso. A angina abdominal foi totalmente resolvida após estabilização do quadro. A combinação de abordagem aberta e endovascular deve ser considerada como terapia para casos de dissecção complexa isolada da artéria mesentérica superior.

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“…Diabetes mellitus, hyperlipidemia, and cardiac disease may also be associated with IDSMA but appear to be less relevant [8]. In the acute setting, computed tomography angiography (CTA) with imaging of visceral vessels in an arterial contrast phase is the gold standard [9]. Laboratory values and conventional radiographs of the abdomen are rarely conclusive [10].…”

Section: Introductionmentioning

confidence: 99%

Management of isolated dissection of the superior mesenteric artery

Knarr,

Augustin,

Hartung

et al. 2024

Rofo

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Purpose Isolated dissection of the superior mesenteric artery (IDSMA) is an increasingly frequently diagnosed pathology without a predisposing factor. Different therapeutic options including conservative, endovascular, and open surgical treatment are presented in our single-center study. The follow-up is a special task of different specialties. Methods and Patients A retrospective analysis of six patients with IDSMA was conducted. Patient demographics, clinical presentation, diagnostic management, and therapeutic treatment were assessed. Furthermore, clinical outcome as well as further changes during follow-up were evaluated. Results The majority of the patients were symptomatic with abdominal pain. Of the symptomatic patients, one was managed conservatively, one was treated surgically by patch plasty, and two patients were treated using an endovascular approach. The two asymptomatic patients were each managed conservatively. Conservative therapy was the treatment of choice, especially in asymptomatic and uncomplicated cases with non-persistent symptoms. This was confirmed in our literature review. Computed tomography angiography is the gold standard for follow-up after the acute event or diagnosis. None of our patients needed further treatment after the acute event/detection of IDSMA during the follow-up period with a mean of 68 months. One patient showed significant changes in the diameter of the superior mesenteric artery. Conclusion The appropriate diagnosis, treatment, and follow-up of IDSMA must be tailored to the needs of the individual patient and require multidisciplinary decision making. Key Points:

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Evaluation of isolated abdominal visceral artery dissection with multi-scale spiral computed tomography: a retrospective case series

Cited by 6 publications

References 31 publications

MSCTA imaging analysis of autologous arteriovenous fistula dysfunction in maintenance hemodialysis patients

MSCTA imaging analysis of autologous arteriovenous fistula dysfunction in maintenance hemodialysis patients

Tratamento combinado na dissecção de artéria mesentérica superior: desafio terapêutico

Management of isolated dissection of the superior mesenteric artery

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