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学科主题: 临床医学
题名:
Vasodilator and endovascular therapy for isolated superior mesenteric artery dissection
作者: Luan, Jing Yuan; Li, Xuan; Li, Tian Run; Zhai, Guo Jun; Han, Jin Tao
刊名: JOURNAL OF VASCULAR SURGERY
发表日期: 2013-06-01
DOI: 10.1016/j.jvs.2012.11.121
卷: 57, 期:6, 页:1612-1620
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Surgery ; Peripheral Vascular Disease
研究领域[WOS]: Surgery ; Cardiovascular System & Cardiology
关键词[WOS]: PERCUTANEOUS STENT PLACEMENT ; CONSERVATIVE TREATMENT ; FOLLOW-UP ; ANEURYSM ; MANAGEMENT ; ANGIOGRAPHY ; REPAIR ; HEMORRHAGE
英文摘要:

Objective: We report our experience in the treatment of isolated superior mesenteric artery dissection and review the clinical and imaging features reported in the literature.

Methods: A retrospective study was conducted of 18 consecutive patients with isolated superior mesenteric artery dissection who presented at the Peking University Third Hospital between September 2008 and May 2012. Their clinical characteristics, including age, sex, medical history, risk factors, symptoms, diagnostic imaging modality, and treatment, were analyzed. Also reviewed were 278 patients with isolated superior mesenteric artery dissection reported in the English language literature. The epidemiology, mechanism, clinical presentation, imaging features, and treatment were discussed.

Results: There were 14 men and four women with a mean age of 55.6 years (range, 41-84 years). Four patients were asymptomatic, and 14 presented with acute-onset abdominal pain. The diagnosis was established by contrast- enhanced computed tomography in 17 patients and ultrasound imaging in one patient. All dissections were located at the anterior wall and around the convex curvature of the superior mesenteric artery. The decision to intervene was based on symptoms. Three asymptomatic patients underwent successful conservative management, and one asymptomatic patient with an aneurysmal dilated false lumen underwent endovascular stent placement. For the 14 symptomatic patients, definitive treatment included catheter- directed infusion of a vasodilator in four and stent placement combined with catheter- directed infusion of a vasodilator in 10, of whom one patient underwent hybrid stent placement. No complications or deaths occurred. During the mean 14.9- month (range, 1-40 month) follow-up period, all patients were asymptomatic, and patency of the superior mesenteric artery was demonstrated by contrast- enhanced computed tomography scan.

Conclusions: Conservative management can be applied to asymptomatic patients with isolated superior mesenteric artery dissection. For symptomatic patients, stent placement is the definitive treatment if there is no arterial rupture or intestinal necrosis. Self-expanding bare stents that completely cover the curvature of the superior mesenteric artery are recommended. Catheter-directed infusion of a vasodilator can be an effective accessional process after stent placement.

语种: 英语
WOS记录号: WOS:000319389400027
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/59054
Appears in Collections:北京大学第三临床医学院_期刊论文

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作者单位: Peking Univ, Hosp 3, Dept Intervent Radiol & Vasc Surg, Beijing 100191, Peoples R China

Recommended Citation:
Luan, Jing Yuan,Li, Xuan,Li, Tian Run,et al. Vasodilator and endovascular therapy for isolated superior mesenteric artery dissection[J]. JOURNAL OF VASCULAR SURGERY,2013,57(6):1612-1620.
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