J Korean Soc Traumatol.  2015 Dec;28(4):266-271. 10.0000/jti.2015.28.4.266.

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

• Kim YK
• Her KH
• Kim SH
• Kim K

• KMID: 2224038
• DOI: http://doi.org/10.0000/jti.2015.28.4.266

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 anticoagulants. 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.

Keyword

Superior mesenteric artery dissection; Blunt trauma; Endovascular stent placement

MeSH Terms

Aneurysm
Aneurysm, Dissecting*
Anticoagulants
Female
Follow-Up Studies
Humans
Mesenteric Artery, Superior*
Middle Aged
Stents*
Visceral Pain
Anticoagulants