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Superior mesenteric artery aneurysms: is presence an indication for intervention?
W M Stone1, M Abbas, Kenneth J Cherry
1Division of Vascular Surgery, Mayo Clinic Scottsdale, Scottsdale, AZ 85251, USA.
Journal of Vascular Surgery
|August 10, 2002
Summary
Superior mesenteric artery (SMA) aneurysms pose a higher rupture risk than previously thought, especially in males and noncalcified cases. Intervention is advised for eligible patients due to this elevated risk.
Area of Science:
- Vascular Surgery
- Abdominal Aortic Aneurysms
- Gastrointestinal Surgery
Background:
- Superior mesenteric artery (SMA) aneurysms are rare but carry a significant risk of rupture.
- Previous studies suggested a low rupture risk, leading to varied recommendations for intervention.
- This study reviews institutional experience to clarify indications for SMA aneurysm repair.
Purpose of the Study:
- To determine the rupture risk of superior mesenteric artery aneurysms.
- To identify patient and aneurysm characteristics associated with rupture.
- To evaluate the outcomes of intervention versus observation for SMA aneurysms.
Main Methods:
- Retrospective review of medical records for true SMA aneurysms from 1980-1998.
- Inclusion criteria focused solely on true SMA aneurysms.
- Data analysis included patient demographics, aneurysm characteristics, treatment, and outcomes.
Main Results:
- Twenty-one true SMA aneurysms were identified, representing 6.9% of visceral aneurysms.
- Rupture occurred in 38% of patients at presentation, with higher rates in males (50%) and noncalcified aneurysms.
- Operative intervention in 11 patients had a 37.5% mortality for ruptured cases; observation of 10 patients showed no mortality.
Conclusions:
- SMA aneurysms exhibit a higher rupture risk than previously reported.
- Male sex and noncalcified aneurysms are associated with increased rupture risk.
- Beta-blocker therapy may offer a protective effect; intervention is recommended for eligible patients.
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