MISC 13. Analysis of Prognosis and Predictors for Spontaneous Isolated Superior Mesenteric Artery Dissection

Abstract

The objective of this study was to analyze the prognosis and predictors for patients with spontaneous isolated superior mesenteric artery (SMA) dissection (SISMAD). A total of 147 consecutive SISMAD patients from 2013 to 2017 were evaluated retrospectively. Forty-eight clinical, radiologic, and laboratory prognostic factors were counted and evaluated using univariate and multivariate logistic regression analyses. The follow-up time was 6 to 66 months (average, 31 months). Complete remodeling was observed in 32 patients (22%). The independent predictors were heart rate (hazard ratio [HR], 0.358; P = .031), alcoholism (HR, 0.272; P = .023), SMA normal diameter (HR, 2.674; P = .047), and SMA thrombosis (HR, 0.186; P = .009). Thirty-eight patients (26%) still had clinical symptoms, and body mass index (HR, 2.735; P = .036), initial symptoms (HR, 2.534; P = .045), and aorta-SMA angle (HR, 0.418; P = .049) were demonstrated to be significant predictors. The radiologic and clinical prognoses were inconsistent in 89 patients and associated with initial symptoms (HR, 0.288; P = .004) and SMA normal diameter (HR, 2.894; P = .016). The overall prognosis of SISMAD was fine. However, the rates of complete remodeling and complete recovery of symptoms were relatively low, and the radiologic and clinical prognoses were inconsistent.