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Mesenteric Artery Dissection and Wall-Thickening, Case Study and General Review

Nedaa Skeik1,2, Jenna Smith2, Sydney L Olson3

  • 1Section of Vascular and Endovascular Surgery, Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, MN, USA.

Angiology
|August 3, 2022
PubMed

Insights

Mesenteric artery dissection and wall-thickening are rare conditions. Most patients with these vasculopathies improved with conservative management, with high survival rates and symptom relief.

Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Radiology

Background:

  • Mesenteric artery dissection (D) and wall-thickening (WT) are uncommon vasculopathies.
  • These conditions can lead to severe complications if not managed properly.

Purpose of the Study:

  • To analyze the diagnosis and management of mesenteric artery D and WT.
  • To review patient outcomes and identify effective treatment strategies.

Main Methods:

  • Single-center analysis of 101 patients evaluated for mesenteric D and/or WT between 2000 and 2020.
  • Review of patient demographics, etiologies, clinical presentations, management strategies, and outcomes.

Main Results:

  • The average patient age was 55.6 years, with a predominantly male demographic (62%).
  • Common etiologies included segmental arterial mediolysis (SAM), isolated dissection, vasculitis, fibromuscular dysplasia (FMD), and aortic dissection extension.
  • Most patients presented with abdominal pain; hypertension, hyperlipidemia, and tobacco use were prevalent comorbidities.
  • Management involved conservative (22%), medical (47%), endovascular (19%), and open repair (12%) approaches.
  • High in-hospital survival (98%) and symptom relief (73%) were observed.

Conclusions:

  • Conservative management is effective for many patients with mesenteric vasculopathies.
  • Endovascular or surgical interventions are reserved for symptomatic patients with complex presentations.
  • This study contributes to the limited literature on diagnosing and managing rare mesenteric vasculopathies.
Keywords:
dissectionmedical managementmesenteric arteryrevascularizationwall thickening

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