Spontaneous Isolated Dissection of the Superior Mesenteric Artery.

Abstract

A case of a 63-year-old man with isolated dissection of the superior mesenteric artery (SMA), demonstrated by enhanced computed tomography (CT) and abdominal angiography, was admitted to our hospital. The severity of this disease varies from mild to severe; the severe cases require surgery. But the mild cases, like the one presented here, only need conservative therapy. This case demonstrated the usefulness of anticoagulation therapy and the indications for surgical and radiological intervention. (Intrenal Medicine 41: 713-716, 2002)

Three isolated superior mesenteric artery dissections: Update of previous case reports, diagnostics, and treatment options

“…Endovascular intervention involves stent placement or thrombolytics. Indications for surgical repair have been previously described as increasing aneurysmal dilation, thrombosis of the SMA true lumen, persistent symptoms despite anticoagulation, 35 year. One report details the failure of anticoagulation after 1 year.…”

Isolated dissection of the superior mesenteric artery: a case report and literature review

“…40 Some treatment algorithms for the management of spontaneous SMA dissection have been reported in literature, but, to date, there is no established, unanimous opinion about conservative medical management, endovascular therapy, or surgical revascularization. Some cases have been successfully treated by conservative therapy, such as anticoagulant drugs, 41,42 but there is not enough experience to demonstrate that the efficacy and safety of this approach are superior to those of other approaches. However, most of the reports agree about the following therapeutic strategies: 43 i) patients without imminent vessel rupture, symptoms of bowel ischemia or peritoneal signs: conservative treatment; ii) patients with an increased risk of perioperative complications, without severe mesenteric ischemia or peritonitis: percutaneous endovascular stent placement; iii) luminal thrombosis, increasing size of SMA aneurysmal dilatation, peritoneal signs, or persistent symptoms despite anticoagulation: open surgery (aorto-mesenteric or ilio-mesenteric bypass, thrombectomy, intimectomy, with or without patch angioplasty, ligation and resection).…”

Dissection isolée de l’artère mésentérique supérieure : à propos d’un cas

“…À la différence de la dissection aortique, la dissection spontanée et isolée d'une artère périphérique, en l'absence d'anomalie évidente du tissu conjonctif, est extrêmement rare [1,2]. Par ordre d'incidence croissant, ce type de dissection isolée peut impliquer les artères rénales, carotides, coronaires, intracrâ-niennes ou viscérales [3].…”