Vasodilator and endovascular therapy for isolated superior mesenteric artery dissection Jing Yuan Luan, MD, Xuan Li, MD, Tian Run Li, MD, Guo Jun Zhai,

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Presentation transcript:

Vasodilator and endovascular therapy for isolated superior mesenteric artery dissection Jing Yuan Luan, MD, Xuan Li, MD, Tian Run Li, MD, Guo Jun Zhai, MD, Jin Tao Han, MD Journal of Vascular Surgery Volume 57, Issue 6, Pages 1612-1620 (June 2013) DOI: 10.1016/j.jvs.2012.11.121 Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 1 A 76-year-old man with spontaneous isolated dissection of the superior mesenteric artery who was asymptomatic and detected incidentally. A and B, Contrast-enhanced computed tomography (CT) scan demonstrates the dissection and the true lumen is compressed by the aneurysmal dilated false lumen (white arrows), which is 26 mm at the largest diameter. C and D, Contrast-enhanced CT scan at 19 months after placement of a self-expanding 8-mm × 80-mm bare stent (Protégé GPS; ev3 Endovascular, Inc, Plymouth, Minn) shows the patency of the stent and remarkable shrinkage of the dissecting aneurysm. Journal of Vascular Surgery 2013 57, 1612-1620DOI: (10.1016/j.jvs.2012.11.121) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 2 A 46-year-old man with isolated dissection of the superior mesenteric artery who was involved in recent traffic accident while wearing a seat belt. A, Contrast-enhanced computed tomography (CT) scan demonstrates isolated dissection of the superior mesenteric artery and the true lumen is stenosis compressed by the false lumen. B, After 2 hours, angiography shows occlusion of the superior mesenteric artery. C, After the placement of an 8-mm × 40-mm Precise stent (Cordis, Miami, Fla), the angiography shows the superior mesenteric artery is patent. Journal of Vascular Surgery 2013 57, 1612-1620DOI: (10.1016/j.jvs.2012.11.121) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 3 A 48-year-old man with spontaneous isolated dissection of the superior mesenteric artery undergoes hybrid stent placement. A, Angiography shows occlusion of the superior mesenteric artery. B, After an unsuccessful transfemoral approach, a guidewire is inserted into the true lumen through a transmesenteric artery approach under laparotomy. C, After the hybrid stent (Astron 7-mm × 60-mm [BIOTRONIK SE & Co KG, Berlin, Germany] and SMART 8-mm × 80-mm [Cordis, Miami, Fla]) placement, angiography shows a patent superior mesenteric artery. D, Contrast-enhanced computed tomography (CT) after 22 months shows the patency of the superior mesenteric artery. Journal of Vascular Surgery 2013 57, 1612-1620DOI: (10.1016/j.jvs.2012.11.121) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 4 Flow diagram of treatment for isolated superior mesenteric artery dissection. CT, Computed tomography. Journal of Vascular Surgery 2013 57, 1612-1620DOI: (10.1016/j.jvs.2012.11.121) Copyright © 2013 Society for Vascular Surgery Terms and Conditions