scholarly journals Clinical Outcomes of Conservative Treatment in Patients with Symptomatic Isolated Spontaneous Renal Artery Dissection and Comparison with Superior Mesenteric Artery Dissection

2018 ◽  
Vol 56 (2) ◽  
pp. 291-297 ◽  
Author(s):  
Min-Jae Jeong ◽  
Hyunwook Kwon ◽  
Amy Kim ◽  
Gi-Young Ko ◽  
Youngjin Han ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Renal Artery ◽  
Superior Mesenteric Artery ◽  
Clinical Outcomes ◽  
Mesenteric Artery ◽  
Artery Dissection ◽  
Superior Mesenteric Artery Dissection

scholarly journals Spontaneous Renal Artery Dissection in a Man with Previous Spontaneous Superior Mesenteric Artery Dissection

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Yujiro Yokoyama ◽  
Masato Nakajima
Keyword(s):  
Renal Artery ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Rare Case ◽  
Visceral Artery ◽  
Artery Dissection ◽  
History Of ◽  
Natural Histories ◽  
Superior Mesenteric Artery Dissection ◽  
Device Technology

Both spontaneous superior mesenteric artery dissection (SMAD) and spontaneous renal artery dissection (SRAD) are very rare conditions. Their etiologies and natural histories are not precisely defined, but they are thought to be associated with underlying conditions. In this report, we describe an extremely rare case of SRAD in a man who had a history of spontaneous SMAD. We successfully treated SRAD with endovascular intervention. Isolated spontaneous SMAD and SRAD are both rare conditions. Their optimal treatment has not been established due to their rare entities, but endovascular treatment is a good option because it can prevent both advancement of infarction and renovascular hypertension, and it has become safer as device technology has improved. Patients with isolated visceral artery dissection should be carefully followed up.

Treatment Strategies and Outcomes of Symptomatic Spontaneous Isolated Superior Mesenteric Artery Dissection: A Systematic Review and Meta-analysis

2018 ◽  
Vol 25 (5) ◽  
pp. 640-648 ◽  
Author(s):  
Yating Zhu ◽  
Yanghong Peng ◽  
Mingyue Xu ◽  
Yingqi Wei ◽  
Shanshan Wu ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Superior Mesenteric Artery ◽  
Success Rate ◽  
Antithrombotic Therapy ◽  
Mesenteric Artery ◽  
Meta Analysis ◽  
Case Series ◽  
Treatment Modalities ◽  
Artery Dissection ◽  
Superior Mesenteric Artery Dissection

Purpose: To analyze the published treatment experience with symptomatic spontaneous isolated superior mesenteric artery dissection (SISMAD). Methods: A literature search of the PubMed and Cochrane databases was conducted for articles on symptomatic SISMAD published in English from January 2007 to January 2018. Case series reporting on both treatment modalities and outcomes were included, while those on traumatic or iatrogenic SMA dissection or SMA dissection accompanied by aortic or other visceral artery dissection were excluded. Overall event rates for treated symptomatic SISMAD were calculated using pooled analyses. The rate of initial conservative treatment, the success rate, the rate of conversion to intervention, and the failure rate in patients with vs without antithrombotic therapy were calculated for each study and compared using a meta-analysis of proportions. Results: The 25 articles selected encompassed 616 SISMAD cases, of which 514 were symptomatic cases eligible for the analysis. Among the latter, initial treatment consisted of conservative therapy in 447 (87.0%) patients and surgical interventions in 67 (13.0%) patients [45 (8.7%) endovascular procedures and 22 (4.3%) open surgeries]. Among conservative cases, 238 (53.2%) received antithrombotic therapy while 172 (38.5%) did not; 50 (11.2%) cases were converted to intervention [42 (84%) endovascular]. Conservative treatment was initially used in 85.2% of pooled cases with an 84.7% success rate, a 14.3% rate of conversion to intervention, and conservative treatment failure rates of 17.8% and 10.1% in patients treated with vs without antithrombotic therapy, respectively (p=0.103). Conclusion: Conservative treatment appeared safe and effective in >80% of symptomatic SISMAD cases, without apparent benefit for antithrombotic agent use. Initial or secondary intervention was more often endovascular, with favorable success rates and short-term outcomes. Large, prospective randomized trials with long-term follow-up are warranted on the treatment for symptomatic SISMAD.

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