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Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
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Management of isolated superior mesenteric artery dissection
Peng-Hua Lv1, Xi-Cheng Zhang1, Li-Fu Wang1
1Peng-Hua Lv, Li-Fu Wang, Department of Interventional Radiology, Northern Jiangsu People's Hospital, Yangzhou 225001, Jiangsu Province, China.
World Journal of Gastroenterology
|December 11, 2014
Summary
Spontaneous isolated superior mesenteric artery dissection (ISMAD) can be managed with conservative therapy, endovascular stenting, or surgery. Conservative management is the first-line option for ISMAD, with interventions reserved for severe cases.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Gastroenterology
Background:
- Spontaneous isolated superior mesenteric artery dissection (ISMAD) is a rare condition.
- Effective management strategies for ISMAD are crucial for patient outcomes.
Purpose of the Study:
- To evaluate the clinical management and outcomes of spontaneous isolated superior mesenteric artery dissection (ISMAD).
Main Methods:
- Retrospective analysis of 18 patients with ISMAD from January 2008 to July 2013.
- Treatment strategies included conservative therapy (7 patients), endovascular stenting (9 patients), and surgical treatment (2 patients).
- Treatment decisions were based on patient-specific factors like anatomy, comorbidities, and symptoms.
Main Results:
- Conservative therapy led to complete resolution of intestinal ischemia symptoms in all treated patients.
- Endovascular stenting was successful in 9 patients, alleviating abdominal pain within 3 days and showing patent stents on follow-up imaging.
- Surgical treatment in 2 patients also demonstrated good clinical efficacy.
Conclusions:
- ISMAD can be successfully managed using various approaches tailored to clinical presentation.
- Conservative management is recommended as the initial treatment for ISMAD.
- Endovascular or surgical interventions are indicated for patients with bowel necrosis or risk of arterial rupture during conservative therapy.
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