Transcatheter arterial embolization for segmental arterial mediolysis.
OBJECTIVE
To report outcomes of transcatheter arterial embolization for segmental arterial mediolysis (SAM), a vascular disorder characterized by angiographically documented fusiform aneurysms separated by areas of normal appearing vessel in the celiac or mesenteric arteries.


METHODS
Four patients (3 men; median age 70 years, range 57-77) had a presumptive diagnosis of SAM; the possibility of vasculitis was ruled out based on clinical and laboratory findings. Three patients were symptomatic, with aneurysm rupture; the fourth patient was diagnosed incidentally. Coil embolization was used in 3 cases and N-butyl cyanoacrylate in the other. There was no re-rupture. One patient developed a focal dissection of the superior mesenteric artery 9 months after middle colic artery embolization. Another patient died of perforation of the lower gastrointestinal tract 3 months after treatment, but the cause was unknown; mesenteric ischemia from embolization and arteriopathy could not be ruled out.


CONCLUSIONS
Transcatheter embolization is useful for SAM. However, it is likely that the morphology associated with SAM transforms rapidly, so patients undergoing mesenteric artery embolization should be monitored at short intervals.
Shimohira
Masashi
M
Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. m_shimohira@yahoo.co.jp
Ogino
Hiroyuki
H
Sasaki
Shigeru
S
Ishikawa
Kiichi
K
Koyama
Masashi
M
Watanabe
Kenichi
K
Shibamoto
Yuta
Y
D000368:Aged; D000792:Angiography; D001158:Arteries / Q000473:pathology*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014652:Vascular Diseases / Q000473:pathology* / Q000628:therapy*