title: Superior mesenteric artery dissection as a complication of an endovascular attempt to treat aneurysms of the pancreaticoduodenal arteries.
abstract: A case of iatrogenic dissection of the superior mesenteric artery (SMA) in a 42-year old woman during an attempt of endovascular treatment of aneurysms of the pancreaticoduodenal arteries coexisting with a stenosis of the coeliac trunk is presented. The dissection occurred most probably during insertion of an introducer sheath into the SMA. The patient at that moment reported a short-lasting abdominal pain and after that remained asymptomatic. Due to technical difficulties, the attempt of endovascular management of pancreaticoduodenal aneurysms was abandoned. The completion angiography revealed the occlusion of the SMA. The patient underwent an emergency laparotomy; pancreaticoduodenal aneurysms were excised and SMA dissection was repaired with endarterectomy and a patch closure. Postoperative recovery was uneventful and the patient remained asymptomatic during a 30-month follow-up. The case underscores the importance of completion angiography after endovascular interventions in the SMA since the early period of its occlusion may be asymptomatic.
authors.affiliation: Department and Clinic of General and Vascular Surgery, Poznan University of Medical Sciences, Poznań, Poland.
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Dzieciuchowicz
authors.affiliation: Department and Clinic of General and Vascular Surgery, Poznan University of Medical Sciences, Poznań, Poland magdalena.snoch@gmail.com.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Snoch-Ziółkiewicz
authors.affiliation: Department and Clinic of General and Vascular Surgery, Poznan University of Medical Sciences, Poznań, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Oszkinis
authors.affiliation: Department of Radiology, Poznan University of Medical Sciences, Poznań, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Frankiewicz
mesh_terms: D000328:Adult; D000783:Aneurysm / Q000601:surgery*; D000784:Aortic Dissection / Q000209:etiology / Q000601:surgery; D001158:Arteries / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D004386:Duodenum / Q000098:blood supply*; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D017538:Mesenteric Artery, Superior / Q000293:injuries*; D010179:Pancreas / Q000098:blood supply*; D016896:Treatment Outcome
keywords: Complications of endovascular repair; Pancreaticoduodenal artery aneurysm; Superior mesenteric artery dissection