Endovascular Stent Placement in a Patient with a Posttraumatic Isolated Superior Mesenteric Artery Dissection with Focally Progressing Dissecting Aneurysms and a Severely Compressed True Lumen

외상 후 단독 상장간막동맥박리 후에 국소적으로 진행된 박리성 동맥류와 심한 진강의 압박이 있는 환자에서 혈관내 스텐트설치술 1례

  • Kim, Young-Kyu (Department of Surgery, Jeju National University School of Medicine) ;
  • Her, Kyu Hee (Department of Surgery, Jeju National University School of Medicine) ;
  • Kim, Seung Hyoung (Department of Radiology, Jeju National University School of Medicine) ;
  • Kim, Kwangsik (Department of Surgery, Jeju National University School of Medicine)
  • 김영규 (제주대학교 의학전문대학원 외과학교실) ;
  • 허규희 (제주대학교 의학전문대학원 외과학교실) ;
  • 김승형 (제주대학교 의학전문대학원 영상의학교실) ;
  • 김광식 (제주대학교 의학전문대학원 외과학교실)
  • Received : 2014.10.12
  • Accepted : 2015.12.07
  • Published : 2015.12.31

Abstract

Reports on a posttraumatic isolated superior mesenteric artery (SMA) dissection are rare. Recently, endovascular stent placement via percutaneous access, instead of vascular surgery, has been widely accepted as the initial treatment for a patient with an isolated SMA dissection or its complications. A 60-year-old female patient was transferred to our hospital due to an isolated SMA dissection after a car accident. The SMA dissection was 8.5 cm in length, and it involved the true lumen, which was severely compressed by the thrombosed false lumen. The patient was closely observed because she did not complain of any specific visceral pain. On the seventh hospital day, she underwent computed tomography (CT) to decide on a further treatment plan, irrespective of the presence of the abdominal symptom. The findings of the follow-up CT showed no difference compared to those of the previous CT. She was discharged with anti-coagulants. One month later, the follow-up CT revealed focally progressing dissecting aneurysms in the false lumen of the dissected SMA and a more severely compressed true lumen. Two self-expandable metallic stents were successfully placed in the true lumen of the dissected SMA, covering two aneurysmal lesions. Herein, we report a successful endovascular treatment with stent placement for treating focally progressing dissecting aneurysms and a severely compressed true lumen in a patient with a posttraumatic isolated SMA dissection.

Keywords

References

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