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Clinical and radiologic course of symptomatic spontaneous isolated dissection of the superior mesenteric artery treated with conservative management 

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Presentation on theme: "Clinical and radiologic course of symptomatic spontaneous isolated dissection of the superior mesenteric artery treated with conservative management "— Presentation transcript:

1 Clinical and radiologic course of symptomatic spontaneous isolated dissection of the superior mesenteric artery treated with conservative management  Hyung-Kee Kim, MD, Hee Kyung Jung, MD, Jayun Cho, MD, Jong-Min Lee, MD, Seung Huh, MD, PhD  Journal of Vascular Surgery  Volume 59, Issue 2, Pages (February 2014) DOI: /j.jvs Copyright © 2014 Society for Vascular Surgery Terms and Conditions

2 Fig 1 Example of serial computed tomography (CT) angiographic findings in group I patient. A, Initial CT scan showing patent false lumen with both entry and re-entry (black arrows); we categorized cases with this finding as group I patients. B, Follow-up CT angiogram at 1 week after conservative treatment shows no interval changes. C, Follow-up CT angiogram at 30 months' follow-up shows sustained patent false lumen with both entry and re-entry and no aneurysmal dilatation. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

3 Fig 2 Example of serial computed tomography (CT) angiographic findings in group II patient (three-dimensional reconstruction of CT angiography [above] and axial view with same level [below]). A, Initial CT scan showing thrombosed false lumen with ulcer-like projection and stenosis of the true lumen (arrow). We categorized cases with these findings and cases with completely thrombosed false lumen as group II patients. B, Follow-up CT angiogram 1 week after conservative treatment shows aggravated stenosis of the true lumen (arrow) progressing to a nearly occluded state despite symptomatic relief. Below, the axial view also shows aggravated stenosis of the true lumen with thrombosis of false lumen (arrowhead). C, Follow-up CT angiogram after 36 months demonstrates improved stenosis of the true lumen (arrow). The axial view (below) also shows improved stenosis of the true lumen and resolution of the thrombosis in the false lumen (arrowhead). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

4 Fig 3 Suggested treatment algorithm for patients with symptomatic spontaneous isolated dissection of superior mesenteric artery (SIDSMA). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

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