Cargando…

Isolated Superior Mesenteric Artery Dissection: A Novel Etiology and a Review

Isolated superior mesenteric artery dissection (ISMAD) is a rare pathology with multifactorial etiology. The aim of this article is to provide a narrative review of the latest literature about ISMAD. Case reports, series, and recent meta-analyses were included. This review is introduced with a brief...

Descripción completa

Detalles Bibliográficos
Autores principales: Eldine, Rakan Nasser, Dehaini, Hassan, Hoballah, Jamal, Haddad, Fady
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Japanese College of Angiology / The Japanese Society for Vascular Surgery / Japanese Society of Phlebology 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958406/
https://www.ncbi.nlm.nih.gov/pubmed/35432650
http://dx.doi.org/10.3400/avd.ra.21-00055
_version_ 1784676937011036160
author Eldine, Rakan Nasser
Dehaini, Hassan
Hoballah, Jamal
Haddad, Fady
author_facet Eldine, Rakan Nasser
Dehaini, Hassan
Hoballah, Jamal
Haddad, Fady
author_sort Eldine, Rakan Nasser
collection PubMed
description Isolated superior mesenteric artery dissection (ISMAD) is a rare pathology with multifactorial etiology. The aim of this article is to provide a narrative review of the latest literature about ISMAD. Case reports, series, and recent meta-analyses were included. This review is introduced with a brief case report of a rare etiology of ISMAD, followed by a discussion of its etiology, clinical presentation, diagnosis, classification, and treatment, and we report a new cause of ISMAD, that is, blunt abdominal trauma. The etiology of ISMAD is multifactorial, consisting of anatomic, genetic, and systemic components. ISMAD is more common among middle-aged males and in East Asia. Its clinical presentation ranges from asymptomatic to mesenteric ischemia, albeit mortality remains <1%. It is diagnosed and classified mostly by computed tomography angiography, and there are five classification systems for ISMAD, though traumatic etiology may be added. The treatment of ISMAD is mostly conservative, with a success rate exceeding 90%. Endovascular stenting is second line, reserved so far for failed medical management, though its role is expanding to include earlier management of symptomatic patients, while open surgical repair is left for acute mesenteric ischemia with bowel compromise.
format Online
Article
Text
id pubmed-8958406
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Japanese College of Angiology / The Japanese Society for Vascular Surgery / Japanese Society of Phlebology
record_format MEDLINE/PubMed
spelling pubmed-89584062022-04-14 Isolated Superior Mesenteric Artery Dissection: A Novel Etiology and a Review Eldine, Rakan Nasser Dehaini, Hassan Hoballah, Jamal Haddad, Fady Ann Vasc Dis Review Article Isolated superior mesenteric artery dissection (ISMAD) is a rare pathology with multifactorial etiology. The aim of this article is to provide a narrative review of the latest literature about ISMAD. Case reports, series, and recent meta-analyses were included. This review is introduced with a brief case report of a rare etiology of ISMAD, followed by a discussion of its etiology, clinical presentation, diagnosis, classification, and treatment, and we report a new cause of ISMAD, that is, blunt abdominal trauma. The etiology of ISMAD is multifactorial, consisting of anatomic, genetic, and systemic components. ISMAD is more common among middle-aged males and in East Asia. Its clinical presentation ranges from asymptomatic to mesenteric ischemia, albeit mortality remains <1%. It is diagnosed and classified mostly by computed tomography angiography, and there are five classification systems for ISMAD, though traumatic etiology may be added. The treatment of ISMAD is mostly conservative, with a success rate exceeding 90%. Endovascular stenting is second line, reserved so far for failed medical management, though its role is expanding to include earlier management of symptomatic patients, while open surgical repair is left for acute mesenteric ischemia with bowel compromise. Japanese College of Angiology / The Japanese Society for Vascular Surgery / Japanese Society of Phlebology 2022-03-25 /pmc/articles/PMC8958406/ /pubmed/35432650 http://dx.doi.org/10.3400/avd.ra.21-00055 Text en © 2022 The Editorial Committee of Annals of Vascular Diseases. https://creativecommons.org/licenses/by/2.5/This article is distributed under the terms of the Creative Commons Attribution License, which permits use, distribution, and reproduction in any medium, provided the credit of the original work, a link to the license, and indication of any change are properly given, and the original work is not used for commercial purposes. Remixed or transformed contributions must be distributed under the same license as the original.
spellingShingle Review Article
Eldine, Rakan Nasser
Dehaini, Hassan
Hoballah, Jamal
Haddad, Fady
Isolated Superior Mesenteric Artery Dissection: A Novel Etiology and a Review
title Isolated Superior Mesenteric Artery Dissection: A Novel Etiology and a Review
title_full Isolated Superior Mesenteric Artery Dissection: A Novel Etiology and a Review
title_fullStr Isolated Superior Mesenteric Artery Dissection: A Novel Etiology and a Review
title_full_unstemmed Isolated Superior Mesenteric Artery Dissection: A Novel Etiology and a Review
title_short Isolated Superior Mesenteric Artery Dissection: A Novel Etiology and a Review
title_sort isolated superior mesenteric artery dissection: a novel etiology and a review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958406/
https://www.ncbi.nlm.nih.gov/pubmed/35432650
http://dx.doi.org/10.3400/avd.ra.21-00055
work_keys_str_mv AT eldinerakannasser isolatedsuperiormesentericarterydissectionanoveletiologyandareview
AT dehainihassan isolatedsuperiormesentericarterydissectionanoveletiologyandareview
AT hoballahjamal isolatedsuperiormesentericarterydissectionanoveletiologyandareview
AT haddadfady isolatedsuperiormesentericarterydissectionanoveletiologyandareview