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Updated: Jun 27, 2026
05:07
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Segmental arterial mediolysis: course, sequelae, prognosis, and pathologic-radiologic correlation.
1Cascade Pathology Group, Department of Pathology, Legacy Emanuel Hospital and Health Center, Portland, OR 97227, USA. rslavin@lhs.org
Summary
Segmental arterial mediolysis is an acute vascular disease causing hemorrhages. Radiologic findings like aneurysms and occlusions correlate with its histologic evolution, aiding diagnosis and prognosis.
Area of Science:
- Vascular Pathology
- Radiology
- Medical Science
Background:
- Segmental arterial mediolysis (SAM) is a vascular disease of presumed vasospastic origin leading to massive hemorrhages.
- Increased case reports highlight SAM, yet uncertainties persist regarding its pathologic-radiologic correlations, disease course, and prognosis.
- This study aims to clarify these aspects of SAM.
Purpose of the Study:
- To correlate radiologic findings with pathologic features of segmental arterial mediolysis.
- To elucidate the natural history and radiologic manifestations of SAM.
- To improve understanding of SAM's prognosis and sequelae.
Main Methods:
- Analysis of 13 radiologic reports of SAM.
- Examination of histologic slides from 25 SAM cases.
- Comparison of radiologic findings with analogous histologic lesions.
Main Results:
- Six angiographic presentations identified: arterial dilatation, single/multiple aneurysms, dissecting hematomas, stenosis, and occlusions.
- Pathologic correlation shows medial muscle loss causes dilatation and aneurysms; dissections and stenoses arise from related processes.
- Common initial findings include aneurysms, dilatation, and occlusions; dissections and stenosis are often delayed.
Conclusions:
- Segmental arterial mediolysis is an acute, self-limited disease.
- Radiologic sequelae include persistent or resolving aneurysms, hematomas, stenosis, and occlusions.
- Subclinical SAM may lead to idiopathic aneurysms or lesions resembling fibromuscular dysplasia.
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