Application of endovascular stent placement as a remedy for spontaneous isolated superior mesenteric artery dissection

Abstract

To present our experience regarding endovascular stent placement for the treatment of spontaneous isolated superior mesenteric artery dissection (SISMAD) and to evaluate the safety and feasibility of the endovascular therapy. The clinical data from six patients with SISMAD who underwent endovascular stent placement in two institutions from March 2010 to May 2012 were analyzed retrospectively. Four patients were implanted a self-expanding stent, and an additional stent was deployed in two of these patients after the first stent was implanted. One patient was subjected to a self-expanding stent implantation combined with coil embolization. The remaining patient underwent thrombectomy plus partial intimectomy 2 months before a balloon-expandable stent was implanted. All of the patients recuperated uneventfully without any reoccurrence of the symptoms in the follow-up period (range 12-38 months). Contrast-enhanced computer tomography scanning was performed 3 months after the procedure in all of the patients, and the images showed that the false lumen was nearly thrombosed and that the true lumen was maintained patent. Endovascular stent placement is a simple and safe alternative to aggressive surgery or uncertain observation.