Endovascular Repair of a Complex Isolated Dissecting Aneurysm of the Superior Mesenteric Artery. (2019)

• Record Type: Journal Article
• Authors: Patelis, Nikolaos; Doukas, Panagiotis; Dodos, Ilias; Karampelas, Taxiarchis; Kanellopoulos, Ilias; Kyriakopoulou, Konstantina; Bisdas, Theodosios
• Is Part Of: EJVES short reports. Volume 44(2019)
• Page Start: 5
• Page End: 8
• Publication Date: 2019
• Subjects: Coiling -- Dissecting aneurysm -- Dissection -- Endovascular -- Mesentery artery; Endoscopic surgery -- Periodicals; Blood-vessels -- Surgery -- Periodicals; 617.413005
• DOI: 10.1016/j.ejvssr.2019.05.003
• Languages: English
• ISSNs: 2405-6553

Abstract

Abstract : Introduction: Isolated dissection of the superior mesenteric artery (SMA) is rare and remains the most common reason for aneurysmal degeneration of the vessel. The treatment is challenging and not standardised. The purpose of this report is to demonstrate that coiling of the false lumen is a good alternative for dissecting SMA aneurysms. Report: A 50 year old male presented with a 3.3 cm dissecting aneurysm of the SMA and epigastric pain of moderate severity. More than 50% of the ileal arteries arose from the collapsed true lumen. Via transfemoral access the true lumen was catheterised. An open cell balloon expandable stent was deployed at the proximal and a closed cell self expandable stent at the distal end of the dissection flap. Through the cells of the first stent a microcatheter was advanced into the false lumen and 33 coils were deployed into the aneurysm sac. A stent graft was deployed within the first stent leading to the total exclusion of the aneurysm. Follow up at three months was uneventful and the patency was assessed by contrast enhanced ultrasound. Discussion: Coiling of the false aneurysm is a good alternative for dissecting SMA aneurysms, where no other open surgical or endovascular options are applicable. Highlights: Spontaneous isolated SMA dissection is the most frequent type of visceral artery dissection. Spontaneous isolated SMA dissection is the most frequent cause of SMA dissecting aneurysms. Treatment of SMA dissecting aneurysms remains controversial. Coiling of the false lumen and stenting of the true lumen is an effective method of treatment.