Endovascular stenting of spontaneous isolated dissection of the superior mesenteric artery: A case report and literature review

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Abstract

Rationale:

Spontaneous isolated dissection of the superior mesenteric artery (SID-SMA) is a rare arterial disease that is difficult to differentiate from other diseases because of lack of specific clinical manifestation and for which there is no available optimal management strategy.

Patient concerns:

A 58-year-old male patient visited our emergency room with sudden onset of moderate-severe epigastric abdominal pain of uncertain cause.

Diagnoses:

Computed tomography scanning showed a characteristic “double lumen sign” of the superior mesenteric artery, and further computed tomography angiography findings revealed a dissected segment of the superior mesenteric artery.

Interventions:

Conservative management was administered for 5 days, but the abdominal pain remained. Subsequently, an endovascular stent was placed in the affected superior mesenteric artery. Postoperative antiplatelet therapy was administered for 6 months.

Outcomes:

The abdominal pain was relieved. Six months later, a follow-up of computed tomography angiography showed that the stent placed had no interval narrowing.

Lessons:

Based on our review and the illustration of this case, endovascular stenting may be a preferred rescue treatment in SID-SMA patients for whom initial conservative treatment fails.

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