Department of Vascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
Vascular Disease Institute, Central South University, Changsha, Hunan, China.
Vascular. 2023 Aug;31(4):668-677. doi: 10.1177/17085381221079992. Epub 2022 Mar 28.
This study aimed to compare the follow-up and outcomes of spontaneous isolated superior mesenteric artery dissection (SISMAD) in different angiographic types and to determine the optimal therapeutic options for SISMAD patients.
This is a retrospective study of 61 SISMAD patients between December 2010 and January 2019 in a single center. Data analysis consisted of demographics, clinical data, radiology review, treatment, follow-up, and outcomes.
A total of 61 SISMAD patients were reviewed in this study. Median age was 53 (quartile, 47.5-63.0), 90.2% were males with hypertension (50.8%), dyslipidaemia (54.1%), and smoking history (60.7%). Among all, 43 patients underwent periodic follow-up of computed tomography (CT) angiography for follow-up analysis. 11 (25.6%) patients showed "No Change" during follow-up, including 6 type I patients. 23 patients (53.5%) were "Partially Remodelled" and 18 of them were type II patients. 7 "Completely Remodelled" patients (16.3%) were all in type II group. Two type III patients (4.6%) died after the emergent surgical intervention within 30 days.
Different SISMAD angiographic types present with variant progression. Type I SISMAD may be inclined to remain "unchanged." Type II SISMAD shows a clear trend to remodeling, especially type IIb patients. The progression of type III SISMAD varies in the extent of collateral bypasses.
本研究旨在比较不同血管造影类型自发性孤立性肠系膜上动脉夹层（SISMAD）的随访结果，并确定 SISMAD 患者的最佳治疗选择。
这是一项单中心回顾性研究，纳入了 2010 年 12 月至 2019 年 1 月期间的 61 例 SISMAD 患者。数据分析包括人口统计学、临床数据、影像学回顾、治疗、随访和结局。
本研究共纳入 61 例 SISMAD 患者。中位年龄为 53 岁（四分位间距，47.5-63.0），90.2%为男性，伴高血压（50.8%）、血脂异常（54.1%）和吸烟史（60.7%）。所有患者中，43 例定期行 CT 血管造影随访。在随访分析中，11 例（25.6%）患者表现为“无变化”，其中 6 例为 I 型。23 例（53.5%）为“部分重塑”，其中 18 例为 II 型。7 例“完全重塑”患者（16.3%）均为 II 型。2 例 III 型患者（4.6%）在 30 天内紧急手术干预后死亡。
不同的 SISMAD 血管造影类型表现出不同的进展趋势。I 型 SISMAD 可能倾向于保持“不变”。II 型 SISMAD 表现出明显的重塑趋势，尤其是 IIb 型患者。III 型 SISMAD 的进展程度因侧支旁路的程度而异。
