H Edward Garrett1. 1. Division of Vascular Surgery, University of Tennessee-Memphis, Memphis, Tenn. Electronic address: egarrettmd@cvsclinic.com.
Abstract
OBJECTIVE: Mesenteric artery dissection was once thought to be rare but has been identified more frequently with increasing use of computerized tomographic angiographic imaging. Multiple reports advocate a wide range of treatment including medical therapy, endovascular, and surgical intervention, with no clear guidelines for the application of each treatment. METHODS: A systematic review of the literature was analyzed and used to create a treatment algorithm that was applied to nine patients in our institution. RESULTS: Although medical therapy is adequate for most patients with mesenteric artery dissection, 14% failed medical therapy, sometimes with severe consequences. Asymptomatic status on presentation predicted successful medical therapy for superior mesenteric artery dissection (P = .0037). CONCLUSIONS: Intensive surveillance is indicated during medical therapy, and invasive intervention may be necessary.
OBJECTIVE: Mesenteric artery dissection was once thought to be rare but has been identified more frequently with increasing use of computerized tomographic angiographic imaging. Multiple reports advocate a wide range of treatment including medical therapy, endovascular, and surgical intervention, with no clear guidelines for the application of each treatment. METHODS: A systematic review of the literature was analyzed and used to create a treatment algorithm that was applied to nine patients in our institution. RESULTS: Although medical therapy is adequate for most patients with mesenteric artery dissection, 14% failed medical therapy, sometimes with severe consequences. Asymptomatic status on presentation predicted successful medical therapy for superior mesenteric artery dissection (P = .0037). CONCLUSIONS: Intensive surveillance is indicated during medical therapy, and invasive intervention may be necessary.