Percutaneous endovascular treatment for isolated spontaneous superior mesenteric artery dissection: report of two cases and literature review.
Isolated spontaneous superior mesenteric artery (SMA) dissection is a rare and sporadically reported condition. Therapeutic options include medical treatment, surgery, and endovascular treatment. However, the optimal treatment strategy has still not been established. We herein present two patients with acute abdomen due to isolated spontaneous SMA dissection, in whom symptoms remained despite initial anticoagulation therapy. Percutaneous endovascular treatment with stenting of the dissected main trunk to achieve complete coverage of the entry site and balloon angioplasty for the distally involved side branches were performed successfully and resulted in complete resolution of the symptoms. According to our experience and previous case reports, early (within 1 week) elective percutaneous endovascular intervention with background anticoagulation therapy is a feasible and effective treatment strategy for symptomatic patients with isolated SMA dissection.
Wu
Xue-Ming
XM
Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Wang
Tzung-Dau
TD
Chen
Ming-Fong
MF
D000006:Abdomen, Acute / Q000209:etiology / Q000601:surgery; D000368:Aged; D000784:Aortic Dissection / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D017130:Angioplasty / Q000295:instrumentation*; D000800:Angioplasty, Balloon / Q000295:instrumentation; D000925:Anticoagulants / Q000627:therapeutic use; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000601:surgery; D008875:Middle Aged; D019518:Postprandial Period; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
D000925:Anticoagulants