Related Experiment Video
Updated: Aug 20, 2025
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Volumetric Analysis of Progressive Remodeling of Isolated Mesenteric Artery Dissection Treated by Conservative
Iannis Ben Abdallah1, Damian Craiem2, Mariano Casciaro3
1Université Paris Cité, Paris, France; Assistance Publique-Hôpitaux de Paris.Nord, Hôpital Bichat, Department of Vascular and Thoracic Surgery and SURVI (Structure d'URgences Vasculaires Intestinales-Intestinal Stroke Center), Paris, France; Inserm, UMR_S 1140, Innovations thérapeutiques en hémostase, Laboratoire de recherches biochirurgicales de la Fondation Carpentier.
Purpose:
To characterize remodeling of conservatively treated isolated mesenteric artery dissection (IMAD) using 3-dimensional (3D) volumetric analysis.
Material And Methods:
Patients with Type I/II (classification of Yun) treated by conservative therapy between January 2018 and January 2020 were prospectively included. Semiautomatic morphological analysis of the superior mesenteric artery (SMA) included volumetric measurements of the true lumen (TL), false lumen (FL), and overall lumen (OL) and 3D aortomesenteric angles from computed tomography angiography data at admission (T0), 1 month (T1), and 12 months (T12). The SMA morphology of patients with IMAD (n = 15, mean age 53 years ± 7; 87% men) was also compared with that of control individuals (n = 51, mean age 56 years ± 4; 94% men).
Results:
A significant reduction in OL volume was observed (P <.001), whereas TL volume remained stable (P =.23). The TL/OL volume ratio significantly increased over time (P =.001) from 53% at T1 to 78% at T12. Aortomesenteric 3D angles at 2, 4, and 6 cm from the ostium showed a progressive decrease toward values observed in the control group (P =.013, P =.002, and P =.027, respectively). At T12, 5 patients (33%) had complete remodeling, and aneurysmal change was observed in 2 patients (<20 mm). Smoking and SMA angle at a distance of 6 cm from the ostium (T0) were the only factors affecting remodeling negatively at T12.
Conclusions:
One-year remodeling in IMAD followed an overall decrease in OL volume related to a decrease in FL volume. Smokers and patients with larger SMA angles at baseline showed poorer remodeling. Spontaneous arterial remodeling in IMAD might favor conservative therapy.
