Spontaneous isolated dissection and atherosclerotic plaques of superior mesenteric artery: the vastly different occurrence site suggests the opposite haemodynamic aetiology

Abstract

The vastly different sites of SIDSMA and atherosclerotic plaque indicate their opposite haemodynamic aetiology. Advances in knowledge: By comparing the location of the two diseases, we demonstrate their different haemodynamic causes.

Management of Spontaneous Isolated Mesenteric Artery Dissection: A Systematic Review

“…The majority of patients, 74%, in this review were not treated with any specific antithrombotic or anticoagulation therapy. Since IMAD is not an atherosclerotic disease ( 106 ), there is no evidence of beneficial effect of antithrombotic therapy ( 107 ). A recent meta-analysis did not recommend the use of additional antithrombotic agents for either symptomatic or asymptomatic SMA dissection, unless further evidence shows any beneficial effect ( 108 ).…”

Long-term outcomes of conservative treatment and endovascular treatment in patients with symptomatic spontaneous isolated superior mesenteric artery dissection: a single-center experience

“…Min and his colleagues compared the occurrence sites of the dissections and atherosclerotic plaques of SMA. The vast differences showed the opposite aetiology of atherosclerotic plaques and dissections [13]. The disease might also be associated with the morphology of SMA, and a case-control study demonstrated that SISMAD patients had larger mean SMAdistal aorta angles than healthy volunteers [14].…”

Isolated Superior Mesenteric Artery Dissection: A Novel Etiology and a Review

“… 14 ) The convexity of SMA after bending causes shear stress to push against the anterior wall, which happens to be the most common site of ISMAD. 15 ) Furthermore, it has been shown that as the angle between the aorta and the SMA’s convex curvature approaches 90°, shear stress and, by extension, ISMAD incidence, increases. 16 , 17 ) The involvement of SMA’s anatomy in ISMAD is supported by Kim’s computational simulation of blood flow.…”

“…18 ) It is noteworthy that in the case reported herein, the very first segment of the SMA is involved, whereby the ISMAD usually spares the first 1.5–3 cm. 15 )…”