Endovascular Treatment Of Spontaneous Isolated Dissection Of The Mesenteric Artery

Objective:To investigate the clinical characteristics and endovascular treatment results of spontaneous isolated mesenteric artery dissection (SIDSMA).Methods:We retrospectively analyzed clinical data of 48 patients who were diagnosed as SIDSMA between January 2013 and June 2014 in The First Affiliated Hospital of Zhejiang University School of Medicine. Including 41 males and 7 females, aged 32 to 78 years, mean (55 ± 8) years. The clinical symptoms of abdominal pain in 45 cases,3 cases of asymptomatic patients treated conservatively. All patients were diagnosed with computed tomography angiography (CTA).Results:In the 45 symptomatic patients, one was treated by laparotomy, SMA thombectomy and necrotic bowel resection.44 patients underwent endovascular treatment, among them 2 patients failed endovascular procedure caused of guidewire unable to enter the true lumen. The other 42 patients underwent successful intravascular remolding.3 asymptomatic patients underwent the conservative treatment. During the mean (17±4) months follow-up period, computed tomography angiography showed patent lumen in all the 42 patients. The 2 patients in which the endovascular intervetion failed remain symptomatic of recurrent abdominal pain and disgestive dysfuction.Conclusions:From this group of patients, the early results of endovascular interventional therapy is safe and effective for SIDSMA.