Tratamento combinado na dissecção de artéria mesentérica superior: desafio terapêutico
Combination treatment for superior mesenteric artery dissection: therapeutic challenge
Guilherme Borgo Ficagna; Cristiano do Carmo Galindo; Jean Paulo Niero Mazon; Gustavo Galvan Debiasi; Amanda Bogo Vargas; Laura Sahd Bernz
Resumo
Palavras-chave
Abstract
Dissection of the superior mesenteric artery is a rare cause of abdominal pain, with a variable clinical picture. It is difficult to diagnose and there is no consensus on treatment options, which range from conservative treatment to open, endovascular, or combination repair. We describe the case of a 45-year-old man with isolated dissection of the superior mesenteric artery and persistent abdominal pain after conservative treatment had been attempted. He underwent open surgical revascularization due to the location and complexity of the dissection. Treatment consisting of endarterectomy, arterioplasty with bovine pericardium patch, and retrograde access to open the mesenteric artery with a stent was successful. Abdominal angina was completely resolved after the condition had stabilized. A combination of open and endovascular approaches should be considered as treatment for cases of isolated complex dissection of the superior mesenteric artery
Keywords
References
1 Tanaka S, Fukuda A, Kawakubo E, Matsumoto T. Superior mesenteric artery dissection with prolonged abdominal angina treated by laparotomy, endarterectomy, patch angioplasty, and retrograde open mesenteric stenting: a case report. Surg Case Rep. 2019;5(1):164.
2 Ullah W, Mukhtar M, Abdullah HM, et al. Diagnosis and management of isolated superior mesenteric artery dissection: A systematic review and meta-analysis. Korean Circ J. 2019;49(5):400-18.
3 Lee A, Frith K. Letters to the editor. Aust Fam Physician. 2016;106(10):699. PMid:27806458.
4 Yun WS, Kim YW, Park KB, et al. Clinical and angiographic follow-up of spontaneous isolated superior mesenteric artery dissection. Eur J Vasc Endovasc Surg. 2009;37(5):572-7.
5 Katsura M, Mototake H, Takara H, Matsushima K. Management of spontaneous isolated dissection of the superior mesenteric artery: case report and literature review. World J Emerg Surg. 2011;6:16.
6 Roussel A, Della Schiava N, Coscas R, et al. Results of retrograde open mesenteric stenting for acute thrombotic mesenteric ischemia. J Vasc Surg. 2019;69(4):1137-42.
7 Gao DN, Qi QH, Gong P. Endovascular stenting of spontaneous isolated dissection of the superior mesenteric artery: a case report and literature review. Medicine. 2017;96(46):e8598.
8 Léonard M, Courtois A, Defraigne J-O, Sakalihasan S. Le cas clinique du mois dissection isolée de l’artère mésentérique supérieure. Rev Med Liege. 2017;72(4):175-180.
9 Hoek J, Helleman J, Jansen J. Spontane dissectie van de A. mesenterica superior. Ned Tijdschr Geneeskd. 2016;160(20)
10 Mitsuoka H, Nakai M, Terai Y, et al. Retrograde stent placement for symptomatic spontaneous isolated dissection of the superior mesenteric artery. Ann Vasc Surg. 2016;35:203.e17-21.
11 Tsuji Y, Hino Y, Sugimoto K, Matsuda H, Okita Y. Surgical intervention for isolated dissecting aneurysm of the superior mesenteric artery - a case report. Vasc Endovascular Surg. 2004;38(5):469-72.
12 Casella IB, Bosch MA, Sousa WO Jr. Isolated spontaneous dissection of the superior mesenteric artery treated by percutaneous stent placement: case report. J Vasc Surg. 2008;47(1):197-200.
13 He Q, Yu F, Fu Y, et al. Evaluation of isolated abdominal visceral artery dissection with multi-scale spiral computed tomography: a retrospective case series. J Cardiothorac Surg. 2021;16(1):61.
14 Garrett HE Jr. Options for treatment of spontaneous mesenteric artery dissection. J Vasc Surg. 2014;59(5):1433-1439.e1-2.
Submitted date:
08/02/2021
Accepted date:
11/22/2021
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email