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Clinical course and angiographic changes of spontaneous isolated superior mesenteric artery dissection after conservative treatment

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Author(s)
Ui Jun ParkHyoung Tae KimWon Hyun ChoYoung Hwan KimTetsuro Miyata
Keimyung Author(s)
Park, Ui JunKim, Hyoung TaeCho, Won HyunKim, Young Hwan
Department
Dept. of Surgery (외과학)
Dept. of Radiology (영상의학)
Journal Title
Surgery Today
Issued Date
2014
Volume
44
Issue
11
Keyword
Superior mesenteric arteryDissectionConservative treatmentRemodeling patternClinical course
Abstract
Purpose The aim of this study was to evaluate the clinical
course and angiographic changes of spontaneous isolated
superior mesenteric artery dissection (SISMAD) after conservative
treatment.
Methods Twenty-four patients with SISMAD admitted
from September 2006 through March 2013 were included
in this study. The clinical characteristics, type and location
of the dissection, clinical outcome and angiographic
changes were analyzed retrospectively.
Results The median follow-up was 18.7 months (range
1.4–67.5 months). Eighteen patients (75 %) were symptomatic,
and themedian duration of abdominal pain was 2.5 days.
All of the patients were treated conservatively. Follow-up
computed tomography angiography showed complete
remodeling in six patients (25 %), partial remodeling in four
patients (17 %), no changes in nine patients (38 %), progression
to total occlusion in four patients (17 %) and aneurysmal
changes of the false lumen in one patient (4 %).
Endovascular intervention was performed in the patient with
aneurysmal changes. There was no mortality or morbidity
related to the dissection.
Conclusion SISMAD represented variable angiographic
changes, and its clinical course was benign in this study.
For patients with SISMAD, if there is no evidence of bowel
infarction, bleeding or aneurysmal changes, conservative
treatment with close follow-up is sufficient and could
reduce unnecessary endovascular interventions.
Keywords Superior mesenteric artery Dissection
Conservative treatment Remodeling pattern
Clinical course
Keimyung Author(s)(Kor)
박의준
김형태
조원현
김영환
Publisher
School of Medicine
Citation
Ui Jun Park et al. (2014). Clinical course and angiographic changes of spontaneous isolated superior mesenteric artery dissection after conservative treatment. Surgery Today, 44(11), 2092–2097. doi: 10.1007/s00595-014-0849-9
Type
Article
ISSN
0941-1291
Source
https://link.springer.com/article/10.1007%2Fs00595-014-0849-9
DOI
10.1007/s00595-014-0849-9
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34436
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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