Strategies of diagnosis and treatment of symptomatic spontaneous isolated superior mesenteric artery dissection
10.13929/j.issn.1672-8475.2020.07.006
- VernacularTitle: 症状性自发孤立性肠系膜动脉夹层诊疗策略
- Author:
Wei CHEN
1
Author Information
1. Department of Interventional Vascular, Shengli Oilfield Central Hospital
- Publication Type:Journal Article
- Keywords:
Anticoagulants;
Antithrombotic;
Diagnosis;
Dissection of artery;
Endovascular treatment;
Superior mesenteric artery
- From:
Chinese Journal of Interventional Imaging and Therapy
2020;17(7):406-410
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the strategies of diagnosis and treatment of symptomatic spontaneous isolated mesenteric artery dissection (SSIMAD). Methods: Data of 44 patients with SSIMAD were retrospectively reviewed, and the strategies of diagnosis and treatment as well as follow-up results were analyzed. Results: Among 44 SSIMAD patients, abdominal pain was the initial symptoms in 39 cases, accompanied by nausea and vomiting in 27 cases. Twenty-eight patients underwent nonsurgical treatment (antithrombotic therapy and expectant treatment), while 13 underwent intraluminal interventional therapy and 3 underwent open surgery. Two cases after nonsurgical treatments and 1 case after surgery were lost. Totally 41 patients were followed up for (32.42±6.67)months. During follow up periods, positive remodeling and negative remodeling were observed in 21 and 5 cases among 25 patients after nonsurgical treatment, while in 10 and 5 cases among 15 patients after intraluminal interventional therapy or open surgery. Conclusion: For acute stage SSIMAD, nonsurgical treatment should be the first-line regimen. Endovascular intervention is safe and feasible if conservative management (≥7 days) fails to relieve persistent abdominal pain symptoms. When peritonitis is present, surgical treatment should be promptly performed.
