Hemodynamic Analysis Of Spontaneous Isolated Superior Mesenteric Artery Dissection

Objective: To provide hemodynamic evidence for the effectiveness of endovascular and conservative treatment approaches for spontaneous isolated superior mesenteric artery dissection(SISMAD)by analyzing hemodynamic data before and after treatment.Methods: We retrospectively analyzed the data of 30 patients with type I and type II SISMAD admitted between November 2015 and March2018.The patients were divided into an endovascular treatment group(12patients)and a conservative treatment group(18 patients).Based on imaging data from computed tomography angiography(CTA),computational fluid dynamics analysis was used to evaluate hemodynamic changes before and after treatment in the 2 groups of patients.Results: Both groups of patients received safe and effective treatment.Hemodynamic results showed low blood flow velocity,high wall pressure,and low wall shear stress(WSS)in the dissected segment of the superior mesenteric artery(SMA),with the false lumen exhibiting the lowest WSS(approximately 0 Pa).Postoperatively,blood flow in the SMA returned to astable level,the wall pressure decreased,and the WSS increased to a stable state in the endovascular treatment group.In the conservative treatment group,false lumen thrombosis and true lumen remodeling were observed;blood flow in the SMA gradually returned to a normal and stable level,the wall pressure gradually decreased,and the WSS gradually increased to a stable state.Conclusion: Hemodynamic parameters following type I and type II SISMAD can gradually return to a stable state after conservative treatment.Therefore,we conclude that conservative treatment,as the preferred strategy for type I and type II SISMAD,is safe and effective.