Nonatherosclerotic Abdominal Vasculopathies

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Cardiology

Background:

• Nonatherosclerotic abdominal arterial vasculopathies (NAVs) encompass rare but significant conditions like mesenteric or renal artery dissection, aneurysm, stenosis, and vasculitis.
• These conditions can lead to life-threatening emergencies, including arterial rupture and hemorrhagic shock.
• This study addresses the scarcity of literature by presenting a center's experience and conducting a comprehensive literature review.

Purpose of the Study:

• To characterize the clinical presentation, etiologies, and management of nonatherosclerotic abdominal arterial vasculopathies (NAVs).
• To analyze treatment outcomes and identify prevalent comorbidities in patients with NAVs.
• To contribute to a better understanding and standardization of NAV management.

Main Methods:

• A single-center retrospective data analysis was performed.
• Subjects aged 18-60 years presenting with NAV between January 2000 and December 2015 were identified.
• 118 patients met the inclusion criteria from a review of 1416 charts.

Main Results:

• The average patient age was 47.0 years, with a predominant female demographic (64%).
• Primary diagnoses included fibromuscular dysplasia (FMD), isolated aneurysms, and median arcuate ligament syndrome (MALS).
• Common comorbidities were tobacco use (43.6%) and hypertension (52.1%). Treatments included coil embolization, anticoagulation, angioplasty/stenting, surgery, and prednisone, with 33.1% managed conservatively. 91.7% showed symptom relief.

Conclusions:

• NAVs are rare, multifactorial conditions predominantly affecting females, with hypertension and tobacco use as prevalent comorbidities.
• Imaging revealed aneurysms, stenosis, dissection, and/or thrombosis in renal and celiac arteries.
• Most patients improved with conservative, medical, endovascular, or surgical interventions, though standardized management approaches require further research.