Superior mesenteric artery aneurysm: 45 years later

Superior mesenteric artery aneurysms (SMAAs) have been described for the past 100 years, with the first successful treatment being published in 1953 by Drs. M.E. DeBakey and D.A. Cooley. It is now 45 years after this first successful treatment, and we have a case study of SMAA that depicts the typical presentation and treatment of such an aneurysm. Our SMAA was repaired with proximal and distal ligation of the aneurysm, with intestinal viability determined by Doppler probe, fluorescein dye and repeated laparotomy in 24 hours. The patient tolerated the procedure well, and there were no postoperative sequelae. In general, SMAAs have a broad range of treatments, including vessel ligation with or without excision, revascularization with primary anastomosis, and obliterative aneurysmorrhaphy. In the future, these SMAAs and other visceral aneurysms can be treated with transluminally placed endovascular grafts with the combined efforts of the vascular surgeon and the interventional radiologist. Our article provides an overall examination of SMAAs with a review of the literature.