title: Therapeutic regimen options for isolated superior mesenteric artery dissection.
abstract: OBJECTIVE
  To summarize the reproducible experience obtained during the treatment of superior mesenteric artery dissection (SMAD) and to investigate the therapeutic options for this condition.
  
  
  METHODS
  The clinical data from 10 patients with SMAD were retrospectively analyzed, including 6 patients receiving conservative therapy, 2 patients receiving endovascular stenting, 1 patient receiving dissecting aneurysm resection plus vascular prosthesis grafting, and 1 patient receiving thrombectomy plus intimectomy.
  
  
  RESULTS
  For the 6 patients subjected to the conservative therapy, the symptoms were thoroughly under control without relapse during the follow-up; for the 2 patients receiving endovascular stenting, the computed tomography (CT) examination performed during the follow-up demonstrated a patent true lumen and an occluded false lumen; for the patient with dissecting aneurysm resection plus vascular prosthesis grafting, a short dissection was observed at the distal end of the vascular prosthesis but without progression during the 14-month follow-up period; for the patient with thrombectomy plus intimectomy, postoperatively, the patient experienced diarrhea, body weight loss, and hypoproteinemia, and CT scanning demonstrated segmental SMA occlusions, which were not fully remitted by conservative therapy until the application of endovascular stenting 4 months later.
  
  
  CONCLUSIONS
  The therapeutic regimen for isolated SMAD should be established based on the clinical symptoms of the patient and the hemodynamic status in SMA. The conservative therapy is mainly indicated for the asymptomatic patients or those with short-term symptoms, while the endovascular or surgical therapy should be recommended for those with persistent intestinal ischemia-related symptoms, rupture of artery, and/or obvious aneurysmal false lumen dilation at a high risk of rupture.
authors.affiliation: Department of Vascular Surgery, Second Hospital Affiliated to Soochow University, Soochow, China.
authors.forename: Xicheng
authors.initials: X
authors.lastname: Zhang
authors.forename: Yuan
authors.initials: Y
authors.lastname: Sun
authors.forename: Zhaolei
authors.initials: Z
authors.lastname: Chen
authors.forename: Xiaoqiang
authors.initials: X
authors.lastname: Li
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D019917:Blood Vessel Prosthesis Implantation; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002681:China; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D015607:Stents; D017131:Thrombectomy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation
chemical_list: D002317:Cardiovascular Agents