Segmental Arterial Mediolysis: Clinical and Imaging Features at Presentation and during Follow-up

Kalva, Sanjeeva P.; Somarouthu, Bhanusupriya; Jaff, Michael R.; Wicky, Stéphan

doi:10.1016/j.jvir.2011.07.001

Cited by 88 publications

(128 citation statements)

References 22 publications

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“…SAM affects systemic blood vessels, recurring or newly developing in another blood vessel after a specific period. 9,10) In three of the four cases, we confirmed old arterial dissection that had developed prior to the present rupture. When SAM is clinically confirmed, blood flow at the lesion site is blocked to prevent hemorrhage in many cases.…”

Section: Discussionsupporting

confidence: 52%

“…3) SAM affects multiple arteries. [3][4][5][6][7][8][9][10] We previously reported a patient who died of SAMrelated subarachnoid hemorrhage, with new/old multiple intracranial artery dissection, 11) and a patient who died of SAM-related intraperitoneal hemorrhage, with old IVA dissection. 12) However, there has been only one case report in which the SAM-related rupture of both intracranial and -peritoneal arteries led to subarachnoid and intraperitoneal hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

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Pathomorphological Examination of Patients with the Simultaneous Rupture of Dissecting Intracranial Vertebral and Intraperitoneal Arteries: Involvement of Segmental Arterial Mediolysis in Intracranial Artery Dissection

Kageyama

Mukai

2018

JNET

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Objective: To examine the involvement of segmental arterial mediolysis (SAM) in intracranial artery dissection. Methods:In four autopsy cases of subarachnoid hemorrhage related to the rupture of the intracranial vertebral artery (IVA) with intraperitoneal hemorrhage, we calculated the extent of arterial dissection using elastica van Gieson staining from the tissue sections of the left/right IVAs and intraperitoneal arteries (IPAs), and examined the properties of the vascular smooth muscle and responses of mesenchymal cells using immunostaining with anti-α smooth muscle antibody (SMA) and anti-S100A4 antibodies. Results:The length of the adventitia at the site of IVA rupture was ≤2.4 mm, and that of disruptions of the internal elastic lamina was 5.4-11 mm. The IVA/IPA rupture sites showed acute arterial dissection. In the blood vessels at the sites of dissection, defect/necrosis of the vascular smooth muscle, which are characteristic of SAM, were noted. In three cases, the topical infiltration of mesenchymal cells was observed in the adventitia at the dissected site of the ruptured IVA. In all cases, dissection of unruptured intracranial or -peritoneal arteries was also present. Its pathological properties vary from acute to old dissection. Conclusion:Autopsy revealed SAM-related systemic multiple arterial dissection in all cases, suggesting the involvement of SAM in the development of intracranial artery dissection.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Pathomorphological Examination of Patients with the Simultaneous Rupture of Dissecting Intracranial Vertebral and Intraperitoneal Arteries: Involvement of Segmental Arterial Mediolysis in Intracranial Artery Dissection

Kageyama

Mukai

2018

JNET

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“…[123][124][125][126][127][128][129] Similar to FMD, segmental arterial mediolysis is a noninflammatory, nonatherosclerotic arterial disease. Although visceral abdominal arteries are most commonly affected, similar histopathology has been documented in intracranial arteries, iliac arteries, and neonatal coronary arteries.…”

Section: Segmental Arterial Mediolysismentioning

confidence: 99%

Fibromuscular Dysplasia: State of the Science and Critical Unanswered Questions

Olin¹,

Gornik²,

Bacharach³

et al. 2014

Circulation

379

490

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“…Thus, patients with extracranial FMD should be screened for intracranial aneurysms and for renal involvement, especially if they are hypertensive. 47 The differential diagnosis of FMD includes atherosclerosis, systemic vasculitis, segmental arterial mediolysis, 48 and arterial aneurysms and dissections from other causes (eg, genetic collagen disorders). It should be noted that in older individuals FMD and atherosclerosis may occur simultaneously (see Figure 1).…”

Section: Fibromuscular Dysplasiamentioning

confidence: 99%