1.Isolated Spontaneous Dissection of Superior Mesenteric Artery: Treated by Percutaneous Endovascular Stent Placement.
Jae Wuk KWAK ; Chang Nyol PAIK ; Kang Moon LEE ; Woo Chul CHUNG ; Sung Hoon JUNG ; Ji Eun KIM ; Jun Hyun BAIK ; Jin Mo YANG
The Korean Journal of Gastroenterology 2010;55(1):58-61
Isolated spontaneous dissection of the superior mesenteric artery (SMA) without aortic dissection is a rare cause of acute mesenteric ischemia. A sudden decrease of intestinal blood flow can lead to fatal complications such as ischemic necrosis, shock, and death. Therefore, early diagnosis and therapeutic approach before the occurrence of intestinal infarction are the most important factor to determine the patient's prognosis. A 52-year-old male presented with postprandial periumbilical pain, and isolated spontaneous dissection of the superior mesenteric artery with mural thrombus was detected by abdominal computed tomography with contrast enhancement. By the percutaneous implantation of vascular metallic stent via femoral artery, he was treated successfully. We report a case of isolated spontaneous dissection of the SMA treated by a percutaneous endovascular stent replacement with a review of literature.
Aneurysm, Dissecting/complications/*diagnosis/surgery
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Humans
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Male
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*Mesenteric Artery, Superior/radiography
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Mesenteric Vascular Occlusion/etiology/surgery
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Middle Aged
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*Stents
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Tomography, X-Ray Computed
2.Isolated Spontaneous Dissection of Superior Mesenteric Artery: Treated by Percutaneous Endovascular Stent Placement.
Jae Wuk KWAK ; Chang Nyol PAIK ; Kang Moon LEE ; Woo Chul CHUNG ; Sung Hoon JUNG ; Ji Eun KIM ; Jun Hyun BAIK ; Jin Mo YANG
The Korean Journal of Gastroenterology 2010;55(1):58-61
Isolated spontaneous dissection of the superior mesenteric artery (SMA) without aortic dissection is a rare cause of acute mesenteric ischemia. A sudden decrease of intestinal blood flow can lead to fatal complications such as ischemic necrosis, shock, and death. Therefore, early diagnosis and therapeutic approach before the occurrence of intestinal infarction are the most important factor to determine the patient's prognosis. A 52-year-old male presented with postprandial periumbilical pain, and isolated spontaneous dissection of the superior mesenteric artery with mural thrombus was detected by abdominal computed tomography with contrast enhancement. By the percutaneous implantation of vascular metallic stent via femoral artery, he was treated successfully. We report a case of isolated spontaneous dissection of the SMA treated by a percutaneous endovascular stent replacement with a review of literature.
Aneurysm, Dissecting/complications/*diagnosis/surgery
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Humans
;
Male
;
*Mesenteric Artery, Superior/radiography
;
Mesenteric Vascular Occlusion/etiology/surgery
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Middle Aged
;
*Stents
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Tomography, X-Ray Computed
3.Clinicopathologic study of ischemic intestinal disease due to mesenteric venous lesions.
Li-feng WANG ; Ming LIU ; Shu-jie ZHANG ; Wei HAN ; Feng GAO ; Ji-ping QI
Chinese Journal of Pathology 2006;35(10):620-622
OBJECTIVETo study the clinical and pathologic features of ischemic intestinal disease due to mesenteric phlebitis.
METHODThe clinical and pathologic features of the mesenteric venous lesions in 3 patients of ischemic intestinal disease admitted during the period from 2003 to 2004 were studied.
RESULTSAll 3 patients had a clinical history of acute abdominal pain accompanying with a diffuse peritonitis. During operation, an infarcted intestinal segment was identified and was resected respectively in each patient. Histologic examination showed a lymphocytic infiltration and fibrinoid necrosis of the small to medium-sized veins, associated with mural thrombosis and infarction of the corresponding intestinal wall and mesentery. The mesenteric arteries were spared. Two-year follow up of one case showed no evidence of local recurrence or systemic vasculitis.
CONCLUSIONSIschemic intestinal disease due to mesenteric phlebitis is a rare entity with a pathological feature of inflammation of venous wall accompanying with the development of mural thrombosis and subsequent haemorrhagic infarction of intestine. The etiology is unknown and surgical resection of the involved intestinal segment is usually recommended.
Adult ; Aged ; Colitis, Ischemic ; etiology ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Intestinal Diseases ; etiology ; pathology ; surgery ; Intestine, Small ; blood supply ; pathology ; surgery ; Ischemia ; complications ; Male ; Mesenteric Vascular Occlusion ; complications ; Mesenteric Veins ; pathology ; Middle Aged ; Phlebitis ; complications
4.Rapidly Aggravated Dissecting Flap by Angiography during Percutaneous Stent Placement for Acute Isolated Superior Mesenteric Artery Dissection.
Hye Jin YANG ; Young Kwon CHO ; Tae Jun SON ; Yoon Young JUNG ; Seung A CHOI ; Suk Hoon LEE
Yonsei Medical Journal 2011;52(5):859-862
Acutely aggravated dissecting flap and consequent occlusion of the superior mesenteric artery (SMA) by simple contrast passage during initial angiography for percutaneous stent placement is a uncommon event, which usually is not reported. After analysis of many factors that underlie development of such complications, we present herein one case of successful treatment of isolated SMA dissection and its complications with favorable outcomes during 25 months follow-up after percutaneous stent placement.
Adult
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Aneurysm, Dissecting/*surgery
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Angiography/adverse effects
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Contrast Media/adverse effects
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Embolectomy
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Humans
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Male
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Mesenteric Artery, Superior/radiography/*surgery
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Mesenteric Vascular Occlusion/etiology
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Stents/*adverse effects
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Tomography, X-Ray Computed
5.Percutaneous Aspiration Embolectomy Using Guiding Catheter for the Superior Mesenteric Artery Embolism.
Kyu Sung CHOI ; Ji Dae KIM ; Hyo Cheol KIM ; Sang Il MIN ; Seung Kee MIN ; Hwan Jun JAE ; Jin Wook CHUNG
Korean Journal of Radiology 2015;16(4):736-743
OBJECTIVE: To evaluate the technical feasibility and clinical outcome of percutaneous aspiration embolectomy for embolic occlusion of the superior mesenteric artery (SMA). MATERIALS AND METHODS: Between January 2010 and December 2013, 9 patients with embolic occlusion of the SMA were treated by percutaneous aspiration embolectomy in 2 academic teaching hospitals. The aspiration embolectomy procedure was performed with the 6-Fr and 7-Fr guiding catheter. Thrombolysis was performed with urokinase using a multiple-sidehole infusion catheter. The clinical outcome was investigated retrospectively. RESULTS: Superior mesenteric artery occlusion was initially diagnosed by computed tomography (CT) in all patients, and all patients had no obvious evidence of bowel infarction on CT scan. Percutaneous aspiration embolectomy was primarily performed in 6 patients, and thrombolysis was initially performed in 3 patients. In 3 patients who received primary thrombolysis, percutaneous aspiration was undertaken because the emboli were resistant to urokinase. Complete angiographic success was achieved in 6 patients and partial angiographic success was accomplished in 3 patients. One patient underwent bowel resection. One patient died of whole bowel necrosis and sepsis, and 8 patients survived without complications. CONCLUSION: Percutaneous aspiration embolectomy is a useful tool in recanalization of embolic occlusion of the SMA in select patients.
Adult
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Aged
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Aged, 80 and over
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Angiography/methods
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Embolectomy/*methods
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Embolism/complications/radiography/*surgery
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Female
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Humans
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Male
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Mesenteric Artery, Superior/radiography/*surgery
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Mesenteric Vascular Occlusion/etiology/radiography/*surgery
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Middle Aged
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Retrospective Studies
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Suction/instrumentation/methods
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Thrombolytic Therapy/methods
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Tomography, X-Ray Computed
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Treatment Outcome
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Urokinase-Type Plasminogen Activator/administration & dosage
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Vascular Access Devices