Abstract:
BACKGROUND:Spontaneous dissection of the superior mesenteric artery (SMA) is exceedingly rare. Treatment options range from observation to anticoagulation to open surgery or endovascular repair. We present our experience to date in the management of isolated SMA dissections. METHODS:A retrospective review of the vascular surgery and radiology databases from 1998 to 2008 was performed. In general, incidental radiologic findings of a dissection were managed expectantly. The decision to intervene was based on anatomic suitability, patient comorbidities and symptoms, and physician preference. Endovascular stents were placed using a brachial approach, with the choice of stent determined by physician preference. Patients who underwent endovascular stent placement (ESP) were maintained on antiplatelet therapy for 6 months postoperatively. Follow-up consisted of yearly office visits and adjunctive computerized tomography (CT) or magnetic resonance imaging (MRI) when clinically indicated. RESULTS:CT or MRI imaging identified nine patients (7 men, 2 women) with an isolated SMA dissection. One patient also had a concomitant celiac artery dissection. Median age was 70 years (range, 46-73 years). Median follow-up time was 32 months (range, 13.8-62.5 months). Presentations included an incidental radiologic finding in three patients and acute onset abdominal pain in six. Treatment included expectant management in four patients, anticoagulation in two, and ESP in three. ESP was performed primarily in two patients and in a third patient after initial management with anticoagulation failed. The reduction in the diameter of the true lumen was significantly greater in patients treated with ESP vs patients who were successfully managed expectantly or with anticoagulation (F = 15.59, P < .005). No procedural complications were associated with ESP. CONCLUSIONS:An isolated SMA dissection is a rare entity that may be managed successfully in a variety of ways based on clinical presentation. Endovascular stenting can be performed with good results and may be the preferred treatment in patients with symptomatic isolated SMA dissections.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Gobble RM,Brill ER,Rockman CB,Hecht EM,Lamparello PJ,Jacobowitz GR,Maldonado TSdoi
10.1016/j.jvs.2009.07.019subject
Has Abstractpub_date
2009-12-01 00:00:00pages
1326-32issue
6eissn
0741-5214issn
1097-6809pii
S0741-5214(09)01387-1journal_volume
50pub_type
杂志文章,评审abstract::Lauded alike by ancient civilizations and modern society, pharaonic Egyptian medicine remains an object of fascination today. This article discusses its surprisingly sophisticated understanding of a cardiovascular system. The term "cardiovascular system," however, carries assumptions and meanings to a modern audience,...
journal_title:Journal of vascular surgery
pub_type: 历史文章,杂志文章
doi:10.1016/j.jvs.2014.04.056
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:The two techniques for carotid endarterectomy (CEA)--conventional (C-CEA) and eversion (E-CEA)--have different effects on blood pressure. This study compared sympathetic activity after C-CEA and E-CEA, as measured by renin and catecholamine levels. METHODS:E-CEA (n = 40) and C-CEA (n = 34) were performed in ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.01.051
更新日期:2012-08-01 00:00:00
abstract::Isolated superior mesenteric artery dissection is a relatively rare vascular pathology. However, the number of recent case reports has shown an increasing incidence with the widespread use of computed tomography imaging for abdominal pain. Here we report three cases of isolated superior mesenteric artery dissection. T...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.08.052
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:The neoaortoiliac system (NAIS) has gained popularity as a durable procedure for treating aortic graft infections. However, one of the disadvantages has been a long operation that can take up to 10 hours. The goal of this study was to assess the feasibility of staging the NAIS procedure with deep vein harves...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.06.067
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVE:Vascular graft and endograft infection (VGEI) has high morbidity and mortality rates. Diagnosis is complicated because symptoms vary and can be nonspecific. A meta-analysis identified 18F-fluoro-d-deoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT) as the most valuable tool for diag...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2020.05.065
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:Favorable outcomes of thoracic endovascular aortic repair (TEVAR) compared with open repair for descending thoracic aortic aneurysms (DTAs) have led to increasing TEVAR use. We evaluated the effect of case volume and hospital teaching status on clinical outcomes of intact DTA repair. METHODS:The Medicare Pro...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.01.035
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:Studies have shown that a sizable percentage of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAAs) is performed outside the instructions for use (IFU). We report our long-term outcomes after EVAR with respect to device-specific IFU. METHODS:Computed tomography angiography data from a c...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.01.034
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:An arteriovenous loop (AVL) enclosed in a polycarbonate chamber in vivo, produces a fibrin exudate which acts as a provisional matrix for the development of a tissue engineered microcirculatory network. OBJECTIVES:By administering enoxaparin sodium - an inhibitor of fibrin polymerization, the significance o...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.05.021
更新日期:2008-10-01 00:00:00
abstract::The hypothesis of the present study is that axillofemoral bypass grafting for acute vascular occlusion has results significantly inferior to an elective procedure. We reviewed 53 patients undergoing primary axillofemoral bypass grafting at the University of Virginia from 1984 to 1989. We found that patients who were a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1991.29422
更新日期:1991-08-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the clinical value and reproducibility of laser Doppler (LD) versus photoplethysmography (PPG) in the measurement of the systolic toe blood pressure. METHODS:Toe blood pressure was measured in 60 patients in different stages of peripheral vascular disease with simult...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.108009
更新日期:2000-12-01 00:00:00
abstract::Despite significant progress in elucidating the pathogenesis of aneurysmal disease, the precise etiology of arterial wall degradation remains unclear. Numerous etiologies have been implicated, including stress-strain factors, structural wall abnormalities, and enzyme imbalance. We have previously shown that collagenas...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1985.avs0020393
更新日期:1985-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to assess the ability of the Pruitt-Inahara shunt to maintain adequate middle cerebral artery velocities during carotid endarterectomy. STUDY DESIGN:Prospectively collected data recorded during 548 carotid endarterectomies performed at a single university hospital were analyzed ...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:10.1067/mva.2000.107565
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:This study examined the outcomes of our novel concept of expanded provisional extension to induce complete attachment strategy (Petticoat) for safety, durability, and remodeling of chronic type B dissections. METHODS:Twenty patients with chronic type B aortic dissection with aneurysmal degeneration qualified...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.01.073
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:Smoking not only increases the risk that coronary heart disease will develop but also morbidity and mortality in patients with known coronary atherosclerosis and after coronary artery bypass grafting. Excessive generation of reactive oxygen species (ROS) has been implicated as the final common pathway for the...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.09.040
更新日期:2010-02-01 00:00:00
abstract:PURPOSE:The outcome of leg bypass in women is unknown. To date, most series of lower extremity bypass have included few women, and the results in women compared with those in men have not been reported. The experience with infrainguinal arterial reconstruction in women treated at the Oregon Health Sciences University h...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1993.48556
更新日期:1993-10-01 00:00:00
abstract::Giant splenic artery aneurysms are extremely rare entities that have important clinical implications. The size and the natural history pose unique challenges in the management of these lesions. We present one such case that was associated with a primary arteriovenous malformation in the splenic hilum. This is the thir...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2006.06.049
更新日期:2006-12-01 00:00:00
abstract::A specific inhibitory factor was isolated from human serum of a patient who manifested impaired prosthetic graft tissue incorporation. The latter reaction was hypothesized to be related to inhibiting fibroblast proliferation by a specific humoral factor. The crude inhibitory serum was tested against a pool of normal h...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1991-07-01 00:00:00
abstract::Four of 32 reported sarcomas related to the aorta have arisen around previously placed aortic vascular prostheses suggesting that the graft may have been an etiologic factor. Our recent experience with such an angiosarcoma arising around a Dacron aortic graft prompted a review of the lesion to identify risk factors, d...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1991-07-01 00:00:00
abstract:OBJECTIVE:This study assessed predictive factors for reintervention after thoracic endovascular aortic repair (TEVAR) for complicated aortic dissection (C-AD). METHODS:An institutional review of consecutive TEVAR for C-AD was performed. RESULTS:Between 2000 and 2011, 41 patients underwent TEVAR for a C-AD involving t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.08.089
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:Based on the significant number of unfilled vascular fellowship positions in the 2004 National Residency Matching Program (NRMP) and the perception of program directors that the quality of candidates is deteriorating, the Issues Committee of the Association of Program Directors in Vascular Surgery (APDVS) exp...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.05.011
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVE:Constriction of vein grafts with braided external nitinol meshes had previously led to the successful elimination of neointimal tissue formation. We investigated whether pulse compliance, smaller kink-free bending radius, and milder medial atrophy can be achieved by knitting the meshes rather than braiding, w...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.05.023
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:Little is known about acute peripheral arterial thrombosis in patients with concomitant cancer. Small studies suggest that revascularization in this patient group is associated with thrombosis and increased risk of amputation and death. We investigated the frequency of cancer in patients operated on for acute...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.06.223
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Sarcopenia has been proposed as a prognostic factor for various diseases. Patients with critical limb ischemia (CLI) have a very poor prognosis, but sarcopenia has not been reported as a prognostic factor for CLI patients. If sarcopenia is associated with the prognosis of CLI patients, it could help select t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.10.094
更新日期:2015-04-01 00:00:00
abstract::Portal and mesenteric venous thrombosis is an uncommon condition that is usually treated with systemic anticoagulation. Catheter-directed thrombolysis via the superior mesenteric artery may be a viable adjunct to treatment of this potentially morbid condition. We present a case of portal and mesenteric venous thrombos...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)01052-8
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVE:This study was conducted to determine the differences in the diameter of the thoracic aorta when measured from electrocardiographic (ECG)-gated and nongated computed tomography (CT) angiography. Another aim was to define the difference in the aortic diameter when it is measured at peak systole and end diastol...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.07.005
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:The optimal revascularization strategy in diabetic patients with chronic critical limb ischemia (CLI) is unclear. This study assessed the efficacy of tailored endovascular-first vs surgical-first revascularization stratified for the presence of diabetes. METHODS:This prospective cohort study, with 1-year fol...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.12.022
更新日期:2007-04-01 00:00:00
abstract::We have developed an infection resistant vascular prosthesis by bonding rifampin to Dacron grafts with the use of a collagen matrix release system. The purpose of this study was to determine the efficacy of this antibiotic-bonded graft in resisting infection after an in situ reconstruction of a previously infected pro...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1992/39117
更新日期:1992-10-01 00:00:00
abstract:BACKGROUND:Despite the current Centers for Medicare and Medicaid Services coverage criteria for carotid artery stenting (CAS), consensus regarding its appropriateness in patients with carotid artery stenosis has not been reached. This is one of the first population-based studies to use a dedicated administrative conven...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2010.05.010
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:Compression of the left common iliac vein (LCIV) by the right common iliac artery is an anatomic variant that may increase the risk for LCIV thrombosis. The incidence of LCIV compression in patients with abdominal aortic aneurysms (AAA) is unknown, however. The aim of this descriptive anatomic study was to de...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.05.046
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVE:In the last decade, there has been a dramatic increase in the number of women entering vascular surgery. Our goal was to evaluate the differences in career paths based on gender and to determine some of the factors that influence career decisions among young vascular surgeons. METHODS:A 17-item web-based sur...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.02.055
更新日期:2017-08-01 00:00:00