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Clinical Outcomes of Anticoagulation Therapy in Patients With Symptomatic Spontaneous Isolated Dissection of the Superior Mesenteric Artery

The aim of this study was to determine the clinical outcomes of long-term anticoagulation therapy in patients with symptomatic spontaneous isolated dissection of the superior mesenteric artery (SIDSMA) and to evaluate whether conservative treatment with anticoagulation therapy is a safe and effectiv...

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Autores principales: Han, Youngjin, Cho, Yong-Pil, Ko, Gi-Young, Seo, Dong Wan, Kim, Min-Ju, Kwon, Hyunwook, Kim, Hyangkyoung, Kwon, Tae-Won
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4845857/
https://www.ncbi.nlm.nih.gov/pubmed/27100453
http://dx.doi.org/10.1097/MD.0000000000003480
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author Han, Youngjin
Cho, Yong-Pil
Ko, Gi-Young
Seo, Dong Wan
Kim, Min-Ju
Kwon, Hyunwook
Kim, Hyangkyoung
Kwon, Tae-Won
author_facet Han, Youngjin
Cho, Yong-Pil
Ko, Gi-Young
Seo, Dong Wan
Kim, Min-Ju
Kwon, Hyunwook
Kim, Hyangkyoung
Kwon, Tae-Won
author_sort Han, Youngjin
collection PubMed
description The aim of this study was to determine the clinical outcomes of long-term anticoagulation therapy in patients with symptomatic spontaneous isolated dissection of the superior mesenteric artery (SIDSMA) and to evaluate whether conservative treatment with anticoagulation therapy is a safe and effective treatment modality for these patients. In this single center, observational cohort study, data from a prospectively recruiting symptomatic SIDSMA registry, including demographics, risk factors of interest, clinical characteristics and outcomes, and initial and follow-up computed tomography angiography (CTA) findings, were analyzed retrospectively. During an 8-year period, a total of 52 consecutive patients who underwent conservative treatment with the use of long-term anticoagulation were included in this study. Clinical symptoms resolved within 11 days in all except 4 patients (7.7%); 3 received endovascular treatment for persistent symptoms and 1 received surgical repair. The mean duration of anticoagulation therapy was 9 (range: 3–60) months. A follow-up CTA showed complete remodeling in 20 (41.7%) patients, and the mean diameter and the incidence of false lumen thrombosis were also decreased significantly. There was no anticoagulation therapy-related mortality or morbidity except 2 (4.2%) minor bleeding complications, and no symptomatic recurrence or aggravation of the dissection occurred during the mean follow-up period of 47.5 (range: 10–97) months. The present study showed that long-term anticoagulation therapy could result in a high rate of complete remodeling during the natural course of symptomatic SIDSMA. Conservative treatment with long-term anticoagulation therapy could be an optimal treatment strategy for symptomatic SIDSMA.
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spelling pubmed-48458572016-05-16 Clinical Outcomes of Anticoagulation Therapy in Patients With Symptomatic Spontaneous Isolated Dissection of the Superior Mesenteric Artery Han, Youngjin Cho, Yong-Pil Ko, Gi-Young Seo, Dong Wan Kim, Min-Ju Kwon, Hyunwook Kim, Hyangkyoung Kwon, Tae-Won Medicine (Baltimore) 3400 The aim of this study was to determine the clinical outcomes of long-term anticoagulation therapy in patients with symptomatic spontaneous isolated dissection of the superior mesenteric artery (SIDSMA) and to evaluate whether conservative treatment with anticoagulation therapy is a safe and effective treatment modality for these patients. In this single center, observational cohort study, data from a prospectively recruiting symptomatic SIDSMA registry, including demographics, risk factors of interest, clinical characteristics and outcomes, and initial and follow-up computed tomography angiography (CTA) findings, were analyzed retrospectively. During an 8-year period, a total of 52 consecutive patients who underwent conservative treatment with the use of long-term anticoagulation were included in this study. Clinical symptoms resolved within 11 days in all except 4 patients (7.7%); 3 received endovascular treatment for persistent symptoms and 1 received surgical repair. The mean duration of anticoagulation therapy was 9 (range: 3–60) months. A follow-up CTA showed complete remodeling in 20 (41.7%) patients, and the mean diameter and the incidence of false lumen thrombosis were also decreased significantly. There was no anticoagulation therapy-related mortality or morbidity except 2 (4.2%) minor bleeding complications, and no symptomatic recurrence or aggravation of the dissection occurred during the mean follow-up period of 47.5 (range: 10–97) months. The present study showed that long-term anticoagulation therapy could result in a high rate of complete remodeling during the natural course of symptomatic SIDSMA. Conservative treatment with long-term anticoagulation therapy could be an optimal treatment strategy for symptomatic SIDSMA. Wolters Kluwer Health 2016-04-22 /pmc/articles/PMC4845857/ /pubmed/27100453 http://dx.doi.org/10.1097/MD.0000000000003480 Text en Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the Creative Commons Attribution-NonCommercial License, where it is permissible to download, share and reproduce the work in any medium, provided it is properly cited. The work cannot be used commercially. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 3400
Han, Youngjin
Cho, Yong-Pil
Ko, Gi-Young
Seo, Dong Wan
Kim, Min-Ju
Kwon, Hyunwook
Kim, Hyangkyoung
Kwon, Tae-Won
Clinical Outcomes of Anticoagulation Therapy in Patients With Symptomatic Spontaneous Isolated Dissection of the Superior Mesenteric Artery
title Clinical Outcomes of Anticoagulation Therapy in Patients With Symptomatic Spontaneous Isolated Dissection of the Superior Mesenteric Artery
title_full Clinical Outcomes of Anticoagulation Therapy in Patients With Symptomatic Spontaneous Isolated Dissection of the Superior Mesenteric Artery
title_fullStr Clinical Outcomes of Anticoagulation Therapy in Patients With Symptomatic Spontaneous Isolated Dissection of the Superior Mesenteric Artery
title_full_unstemmed Clinical Outcomes of Anticoagulation Therapy in Patients With Symptomatic Spontaneous Isolated Dissection of the Superior Mesenteric Artery
title_short Clinical Outcomes of Anticoagulation Therapy in Patients With Symptomatic Spontaneous Isolated Dissection of the Superior Mesenteric Artery
title_sort clinical outcomes of anticoagulation therapy in patients with symptomatic spontaneous isolated dissection of the superior mesenteric artery
topic 3400
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4845857/
https://www.ncbi.nlm.nih.gov/pubmed/27100453
http://dx.doi.org/10.1097/MD.0000000000003480
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