Midterm Outcome of Branch Vessel Stenting for Superior Mesenteric Artery Malperfusion Complicating with Acute Aortic Dissection.

PURPOSE

To investigate the midterm stent patency and patient prognosis after stenting for superior mesenteric artery malperfusion complicating with acute aortic dissection.

MATERIAL AND METHODS

Thirteen patients who underwent branch vessel stenting for superior mesenteric artery malperfusion between 2011 and 2021 in six institutions were retrospectively reviewed. By comparing pre- and postoperative computed tomography scans in the same plane, the length of the stent implanted in the superior mesenteric artery and the stent-to-vessel diameter ratio were measured. The technical and clinical success of stenting, midterm patient prognosis, and stent patency were evaluated.

RESULTS

Superior mesenteric artery stenting was technically successful in 12 patients (92.3%). The mean length of the stents implanted in the superior mesenteric artery was 61.3 ± 39.4 mm (range, 14-127 mm). The mean proximal and distal stent-to-vessel diameter ratios were 1.02 ± 0.16 and 1.30 ± 0.42, respectively. A weak correlation was found between the length of the stents implanted in the superior mesenteric artery and the distal stent-to-vessel diameter ratio (R = 0.34). Two major complications occurred, one of which resulted in death within 30 days, and 12 (92.3%) were clinically successful. Of these 12 patients, no recurrent intestinal ischemia occurred during the follow-up duration (mean, 45.2 months). Partial occlusion of the stent distal edge without intestinal ischemia was observed in one patient (distal stent-to-vessel diameter ratio = 2.33) 42 months after stenting. The overall survival rate and primary stent patency rate were 84.6% and 91.7%, respectively.

CONCLUSIONS

Midterm stent patency and survival after superior mesenteric artery stenting for malperfusion were acceptable.