Medical therapy and intervention do not improve uncomplicated isolated mesenteric artery dissection outcomes over observation alone

Journal of Vascular Surgery
Jacob W LoefflerPeter F Lawrence

Abstract

Isolated dissection of the mesenteric vessels is rare but increasingly recognized. This study aimed to evaluate patient characteristics, primary treatment, and subsequent outcomes of mesenteric dissection using multi-institutional data. All patients at participant hospitals between January 2003 and December 2015 with dissection of the celiac artery (or its branches) or dissection of the superior mesenteric artery (SMA) were included. Patients with an aortic dissection were excluded. Demographic, treatment, and follow-up data were collected. The primary outcomes included late vessel thrombosis (LVT) and aneurysmal degeneration (AD). Twelve institutions identified 227 patients (220 with complete treatment records) with a mean age of 55 ± 12.5 years. Median time to last follow up was 15 months (interquartile range, 3.8-32). Most patients were men (82% vs 18% women) and symptomatic at presentation (162 vs 65 asymptomatic). Isolated SMA dissection was more common than celiac artery dissection (n = 158 and 81, respectively). Concomitant dissection of both arteries was rare (n = 12). The mean dissection length was significantly longer in symptomatic patients than in asymptomatic patients in both the celiac artery (27 vs 18 mm; P = .01...Continue Reading

References

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Aug 28, 2012·Surgery Today·Masatoshi JibikiToshifumi Kudo
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Jul 8, 2016·Vascular Specialist International·Young-Wook Kim

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Citations

Sep 15, 2020·Clinical Practice and Cases in Emergency Medicine·Clifford L FreemanKaran S Shah
Mar 17, 2021·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·S Acosta, F B Gonçalves

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