Outcomes of Spontaneous Isolated Superior Mesenteric Artery Dissection Without Antithrombotic Use. (January 2018)

• Record Type: Journal Article
• Authors: Kim, Hyangkyoung; Park, Hojong; Park, Sang Jun; Park, Bong Won; Hwang, Jae Chol; Seo, Young Woo; Cho, Hong Rae
• Is Part Of: European journal of vascular and endovascular surgery. Volume 55:Number 1(2018)
• Page Start: 132
• Page End: 137
• Publication Date: 2018-01
• Subjects: Dissection -- Mesenteric artery -- Antithrombotic agents -- Treatment outcome; Blood-vessels -- Endoscopic surgery -- Periodicals; Blood-vessels -- Surgery -- Periodicals; Vascular Surgical Procedures -- Periodicals; Vascular Surgical Procedures -- methods -- Periodicals; Vaisseaux sanguins -- Chirurgie -- Périodiques; Vaisseaux sanguins -- Chirurgie endoscopique -- Périodiques; Blood-vessels -- Endoscopic surgery; Blood-vessels -- Surgery; Endoscopy; Electronic journals; Periodicals; Electronic journals; 617.413005
• DOI: 10.1016/j.ejvs.2017.11.002
• Languages: English
• ISSNs: 1078-5884

Abstract

Abstract : Objectives: This study aimed to show the intention to treat results of treatment for spontaneous isolated superior mesenteric artery dissection (SISMAD) without anticoagulation or antiplatelet agents and the follow-up results of SISMAD according to the configuration on computed tomography (CT) scans. Design: Retrospective, observational single centre study Methods: All cases of SISMAD were enrolled consecutively from 2006 onwards. There were 25 symptomatic and four asymptomatic patients in whom SISMAD was found incidentally. The SISMAD patients were treated using a consistent therapeutic strategy without antithrombotics. SISMAD was categorized into four types based on the configuration on CT scans by Yun's classification. Follow-up CT was performed at 3 months, 6 months, and yearly thereafter. Results: The median follow-up duration was 57 months (13–129 months). Improvement or complete resolution on CT scans, with no symptom recurrence, was seen in 27 patients. The non-invasive approach failed in three cases and two patients underwent further intervention. No patient died during the follow-up. Conclusions: Weighing the risks versus benefits of antithrombotics and considering the benign nature of SISMAD, conservative treatment without antithrombotics might be sufficient in patients without evidence of bowel ischaemia or infarction on initial CT scan.