title: Options for treatment of spontaneous mesenteric artery dissection.
abstract: OBJECTIVE
  Mesenteric artery dissection was once thought to be rare but has been identified more frequently with increasing use of computerized tomographic angiographic imaging. Multiple reports advocate a wide range of treatment including medical therapy, endovascular, and surgical intervention, with no clear guidelines for the application of each treatment.
  
  
  METHODS
  A systematic review of the literature was analyzed and used to create a treatment algorithm that was applied to nine patients in our institution.
  
  
  RESULTS
  Although medical therapy is adequate for most patients with mesenteric artery dissection, 14% failed medical therapy, sometimes with severe consequences. Asymptomatic status on presentation predicted successful medical therapy for superior mesenteric artery dissection (P = .0037).
  
  
  CONCLUSIONS
  Intensive surveillance is indicated during medical therapy, and invasive intervention may be necessary.
authors.affiliation: Division of Vascular Surgery, University of Tennessee-Memphis, Memphis, Tenn. Electronic address: egarrettmd@cvsclinic.com.
authors.forename: H Edward
authors.initials: HE
authors.lastname: Garrett
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000784:Aortic Dissection / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D002317:Cardiovascular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D019091:Critical Pathways; D057510:Endovascular Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000601:surgery*; D008875:Middle Aged; D018579:Patient Selection; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects
chemical_list: D002317:Cardiovascular Agents