Read by QxMD icon Read

Management of SMA thrombosis

Joshua Peterson, Anthony N Hage, Stephan Diljak, Benjamin D Long, Daniel P Marcusa, John M Stribley, David W Brzezinski, Jonathan Eliason
BACKGROUND Celiacomesenteric trunk (CMT) is a very rare anatomic finding in which the celiac artery and the superior mesenteric artery (SMA) originate from the abdominal aorta through a common trunk. Clinical associations with CMT include arterial aneurysm, thrombosis, and celiac artery compression. However, an association between CMT and abdominal venous congestion caused by left renal vein compression, or 'nutcracker phenomenon,' has not been previously reported. CASE REPORT A 91-year-old woman, who died from a cerebrovascular accident (CVA), underwent a cadaveric examination at our medical school...
December 15, 2017: American Journal of Case Reports
Jacob W Loeffler, Hideaki Obara, Naoki Fujimura, Paul Bove, Daniel H Newton, Sara L Zettervall, Andre S van Petersen, Robert H Geelkerken, Kristofer M Charlton-Ouw, Sherene Shalhub, Niten Singh, Arnaud Roussel, Natalia O Glebova, Michael P Harlander-Locke, Warren J Gasper, Misty D Humphries, Peter F Lawrence
OBJECTIVE: Isolated dissection of the mesenteric vessels is rare but increasingly recognized. This study aimed to evaluate patient characteristics, primary treatment, and subsequent outcomes of mesenteric dissection using multi-institutional data. METHODS: All patients at participant hospitals between January 2003 and December 2015 with dissection of the celiac artery (or its branches) or dissection of the superior mesenteric artery (SMA) were included. Patients with an aortic dissection were excluded...
July 2017: Journal of Vascular Surgery
Anand Nath, Sayali Yewale, Mohammad Kousha
A true isolated superior mesenteric artery (SMA) dissection is a rare occurrence. The increasing use of diagnostic imaging studies has resulted in this rare disease being more recognized. A 68-year-old Caucasian female presented with sharp upper abdominal pain. Computed tomography (CT) of the abdomen showed dissection with thrombosis in the proximal SMA. Conservative management with bowel rest, blood pressure control, and anticoagulation relieved her symptoms. Follow-up CT showed stable dissection. Physicians should consider the diagnosis of isolated spontaneous SMA dissection after excluding more common causes...
September 2016: Case Reports in Gastroenterology
Mohamed Hedfi, Yosra Messaoudi, Adnen Chouchene
Isolated arterial dissection without aortic pathology has been rarely reported in mesenteric vessels. The natural history and appropriate treatment for this disease is uncertain because of the scarcity of literature which limits the data available to the clinician, resulting in management challenges. Herein, we report a rare case of a 42-year-old Tunisian man with spontaneous dissection and aneurysmal dilatation of the Celiac Artery (CA) and the Superior Mesenteric Artery (SMA) with partial thrombosis. This case was successfully managed conservatively with heparin infusion and blood pressure control and the patient remained symptom free at 15 months follow up...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
Zhihui Dong, Junjie Ning, Weiguo Fu, Daqiao Guo, Xin Xu, Bin Chen, Junhao Jiang, Yuqi Wang
BACKGROUND: To discuss failures and lessons in the endovascular treatment of symptomatic isolated dissection of the superior mesenteric artery (SIDSMA). METHODS: Data from 33 patients with SIDSMA treated between July 2007 and September 2013 were retrospectively collected. The technical failures in and lessons from endovascular management were analyzed in terms of causes and prophylaxis. RESULTS: Eighteen patients were successfully treated medically, 13 underwent stent placement, 1 underwent a hybrid procedure, and 1 had open fenestration...
February 2016: Annals of Vascular Surgery
Hyung-Kee Kim, Hee Kyung Jung, Jayun Cho, Jong-Min Lee, Seung Huh
OBJECTIVE: To determine the clinical and radiological outcomes of patients with symptomatic spontaneous isolated dissection of the superior mesenteric artery (SIDSMA) who were treated with conservative management. METHODS: This retrospective study included 27 consecutive patients who were diagnosed with symptomatic SIDSMA and managed conservatively from April 2007 to April 2013. Twenty-six patients were treated using anticoagulation therapy, and one patient with chronic liver disease underwent observation only...
February 2014: Journal of Vascular Surgery
Stefano Bonardelli, Giuseppe Battaglia, Camilla Zanotti, Edoardo Cervi, Cristina Guadrini, Stefano M Giulini
Isolated dissection of visceral arteries without associated aortic pathology is very rare. Risk factors, etiology, and natural history of this pathology continue to be unclear, and the guidelines for clinical management remain to be defined. We present a case not described previously, with sequential dissections of the celiac trunk, superior mesenteric artery, and renal arteries without aortic involvement. The patient presented with severe back thoracic and abdominal pain and without evidence of peritonitis...
May 2013: Annals of Vascular Surgery
Yan Wang, Mao-qiang Wang, Feng-yong Liu, Zhi-jun Wang, Feng Duan, Peng Song
OBJECTIVE: To evaluate the feasibility and efficacy of urokinase infusion therapy via a transradial approach for transcatheter superior mesenteric artery (SMA) in patients with acute extensive portal and superior mesenteric venous thrombosis. METHODS: During a period of 8 years, 47 patients with acute extensive thrombosis of portal vein (PV) and superior mesenteric veins (SMV) received urokinase infusion therapy by transcatheter selective SMA via radial artery. Their mean age was 44 ± 13 years (range: 19 - 65)...
June 5, 2012: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Bobby V M Dasari, Michael Mullan, Louis Lau, William Loan, Bernard Lee
Superior mesenteric artery (SMA) aneurysms are rare but associated with significant mortality (25-40%) when complicated by rupture or thrombosis. Symptomatic SMA aneurysms, asymptomatic aneurysms of ≥2 cm size and pseudoaneurysms need intervention. We report a case of a 6.5-cm symptomatic SMA aneurysm managed by open surgical repair. At intraoperative exploration, the aneurysm was recognized to be a pseudoaneurysm with a narrow neck (1 mm defect in the native vessel) and was dealt by primary repair. Clinical presentation, the role of radiological investigations and management are discussed...
February 2013: Vascular
Mao Qiang Wang, Li Ping Guo, Han Ying Lin, Feng Yong Liu, Feng Duan, Zhi Jun Wang
The purpose of this investigation was to assess the feasibility and effectiveness of transradial approach for transcatheter superior mesenteric artery (SMA) urokinase infusion therapy in patients with acute extensive portal and superior mesenteric venous thrombosis. During a period of 7 years, 16 patients with acute extensive thrombosis of the portal (PV) and superior mesenteric veins (SMV) were treated by transcatheter selective SMA urokinase infusion therapy by way of the radial artery. The mean age of the patients was 39...
February 2010: Cardiovascular and Interventional Radiology
John G Carson, Gabriel Loor, Micheal J Millis, Giuliano Testa, Giancarlo Piano
Superior mesenteric artery (SMA) aneurysms represent a minority of visceral aneurysms but may result in lethal complications if left untreated. Options for treatment include aneurysmorraphy, bypass, ligation, or embolization. Here we present a case of a man with a history of celiac graft thrombosis who presents with a recurrent symptomatic SMA aneurysm. Given his compromised celiac axis, ligation was not an option. His SMA aneurysm was repaired with a PTFE patch. However, to secure longstanding blood flow to the small bowel in the event of graft thrombosis, the distal SMA pedicle was dissected free of the ileocolic vessels and anastomosed to the aorta...
November 2009: Annals of Vascular Surgery
Philippe Zerbib, Céline Perot, Marc Lambert, Mohamad Seblini, François René Pruvot, Jean Pierre Chambon
PURPOSE: Our objectives were to clarify the management of isolated spontaneous dissection of the superior mesenteric artery (DSMA). METHODS: We reviewed seven patients diagnosed as having DSMA from 2002 to 2007 (group A). Simultaneously, we analyzed 50 cases of DSMA previously reported in the literature between 2000 and 2008 (group B). In each group, clinical presentation, Sakamoto's classification, imaging appearances, need for emergent surgery, failure of medical management, and long-term outcome were analyzed...
April 2010: Langenbeck's Archives of Surgery
Y P Cho, G Y Ko, H K Kim, K M Moon, T W Kwon
BACKGROUND: Spontaneous isolated dissection of the superior mesenteric artery (SMA) is uncommon. Because of its rarity, the risk factors, aetiology and natural history are unclear, and there is no consensus on the optimal treatment strategy. METHODS: Seven consecutive patients with symptomatic spontaneous isolated SMA dissection who received conservative treatment between March 2003 and February 2008 were included in this study. Their clinical characteristics, treatment methods and outcomes were analysed retrospectively...
July 2009: British Journal of Surgery
Lei Wang, Shi-jie Xin, Jian Zhang, Xi-tong Zhang, Dong Yang, Zan-song Zhang, Zhi-quan Duan
OBJECTIVE: To study the management of acute superior mesenteric artery (SMA) ischemia and to improve its prognosis. METHOD: The clinical data of 37 patients treated from January 1996 to August 2007 was retrospectively reviewed. RESULTS: Of the cases, 19 (51.4%) patients were diagnosed with acute SMA embolism, 15 (40.5%) with acute SMA thrombosis, 2 (5.4%) with spontaneous isolated dissection of SMA and 1 (2.7%) with SMA aneurysm. Nineteen (51...
June 1, 2008: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Santi Trimarchi, Valerio S Tolva, Viviana Grassi, Alessandro Frigiola, Mario Carminati, Vincenzo Rampoldi
Descending thoracic and abdominal aortic coarctations are characterized by a segmental narrowing that frequently involves the origin of the visceral and renal arteries. Optimal primary treatment is debated, being reported for both surgical and percutaneous complications. We describe our surgical experience with two youths presenting with failure of distal descending aortic stenting and with abdominal aortic coarctation post-balloon angioplasty, and associated thrombosis of a stented right renal artery and stenosis of the origin of the superior mesenteric artery (SMA)...
April 2008: Journal of Vascular Surgery
Santosh Kumar, A K Mandal, Naveen Acharya, S K Thingnam, Vidur Bhalla, S K Singh
Superior mesenteric artery (SMA) injury is a rare event during abdominal surgery. We report the first case of inadvertent injury of the superior mesenteric artery during surgery of a large malignant adrenocortical tumor with inferior vena cava thrombus. The cause of inadvertent injury was anatomical distortion of the great vessels due to the massive nature of the tumor. The case was managed successfully by immediate end-to-end anastomosis of the superior mesenteric artery.
2007: Urologia Internationalis
Wang Teng, Mark R Sarfati, Michelle T Mueller, Larry W Kraiss
Aneurysms of the pancreaticoduodenal arteries (PDA) are rare, accounting for <2% of all visceral aneurysms. An association with celiac artery stenosis has been reported. Many present with rupture, and a high mortality can be expected. Treatment is therefore challenging. Arterial ligation, anuerysmectomy, or bypass has been the mainstay of treatment. We recently treated a patient (who had no celiac axis) with a ruptured PDA aneurysm with combined open and endovascular techniques. A 46-year-old man was transferred to our hospital with a 1-day history of abdominal pain and syncope...
November 2006: Annals of Vascular Surgery
Stefan Acosta, Mats Ogren, Nils-Herman Sternby, David Bergqvist, Martin Björck
OBJECTIVE: To study findings at autopsy in patients with fatal acute thromboembolic occlusion of the superior mesenteric artery (SMA). SUMMARY BACKGROUND DATA: Acute occlusion of the SMA is difficult to diagnose and mortality remains high. In Malmo, Sweden, the autopsy rate between 1970 and 1982 was 87%, creating possibilities for a population-based study. METHODS: Among 23,496 clinical autopsies and 7569 forensic autopsies, 213 cases with acute thromboembolic occlusion of the SMA and intestinal infarction were identified...
March 2005: Annals of Surgery
Renan Uflacker
Portal vein thrombosis (PVT) is an uncommon cause for presinusoidal portal hypertension. PVT can be caused by one of three broad mechanisms: (1) spontaneous thrombosis when thrombosis develops in the absence of mechanical obstruction, usually in the presence of inherited or acquired hypercoagulable states; (2) intrinsic mechanical obstruction because of vascular injury and scarring or invasion by an intrahepatic or adjacent tumor; or (3) extrinsic constriction by adjacent tumor, lymphadenopathy or inflammatory process...
March 2003: Techniques in Vascular and Interventional Radiology
Guntram Lock
Mortality rates of acute mesenteric ischemia still range between 60 and 100%. Unfortunately, retrospective series have not shown any significant improvement in mortality in the past decades. With approximately 50%, superior mesenteric artery (SMA) embolism is the most common form of acute mesenteric ischemia, followed by SMA thrombosis (approximately 25%), nonocclusive mesenteric ischemia (approximately 20%) and mesenteric venous thrombosis (approximately 5%). Clinical presentation may be unspecific, but is often characterised by an initial discrepancy between severe subjective pain and relatively unspectacular findings on physical examination...
October 2002: Acta Gastro-enterologica Belgica
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"