ABSTRACT
Isolated spontaneous dissection of the superior mesenteric artery (SMA) is a rare cause of acute mesenteric ischemia. Two patients were successfully treated by percutaneous stent placement within the main trunk of the SMA. Emphasis is placed on the feasibility of nonsurgical management with percutaneous stent placement of isolated spontaneous dissection of the SMA.
Subject(s)
Female , Humans , Male , Middle Aged , Aortic Dissection/diagnostic imaging , Angioplasty, Balloon , Mesenteric Artery, Superior/diagnostic imaging , StentsABSTRACT
Endovascular techniques have been used to treat arterial stenosis throughout the vascular system. The goal of this work is to report one case of percutaneous transluminal angioplasty with primary stenting of the ostial segment of the superior mesenteric artery for treatment of chronic mesenteric ischemia.
ABSTRACT
PURPOSE: To determine the effective embolic material and appropriate embolic site by comparing bowel changesafter arterial embolization in dogs in which the proximal or distal level of the superior mesenteric artery hadbeen occluded with gelfoam particles or a coil. MATERIAL AND METHODS: Using the coaxial catheter system,superselective arterial embolization was performed at sixteen sites in four dogs. In groups A and B, each site wasoccluded at the proximal or distal marginal artery, respectively, with gelfoam particles and in groups C and D, atthe proximal or distal artery, respectively, with a coi. All dogs were sacrifed one day after the procedure, andgross and microscopic histologic findings were evaluated. RESULT: In all dogs, the procedure was successful. Ingroup B, significant mucosal destruction, lymphocyte proliferation in submucosa and mucosa, and diffuse swellingin all layers of the intestine were found at all sites. The vessel in the submucosal layer was completelyobstructed by red blood cells and gelfoam.At three sites, the intestine showed diffuse ischemic change, and at oneother site, focal ischemic change was observed. In group D, exudation with destruction of mucosa and submucosalhemorrhage occurred at one site, but in groups A and C, intestinal layers were found to be normal. CONCLUSION: Using a coil, superselective arterial embolization was successful, even up to the distal level of the intestinalartery, and the intestine showed no ischemic change. Embolization with gelfoam must be performed carefully at theproximal level, and since it can cause severe intestinal necrosis, must be avoided at the distal level.
Subject(s)
Animals , Dogs , Arteries , Catheters , Erythrocytes , Gelatin Sponge, Absorbable , Intestines , Lymphocytes , Mesenteric Arteries , Mesenteric Artery, Superior , Mucous Membrane , NecrosisABSTRACT
We recently encountered a case of posttraumatic SMAVF(Superior mesenteric arteriovenous fistula), which has treated by coil embolization. He had history of stab wound and emergent operation. Operative diagnosis was gastric perforation and mesenteric laceration which was simply repaired. After history of abdominal stab woung and operation, he developed palpitation and thrill in left upper abdomen. Recentrly he have experienced syncope twice. On superior mesenteric arteriogram, early visualiation of superior mesenteric vein and portal vein was noted. We embolized the SMAVF by using coils. Since coil embolization, palpitation and thrill disappreared.