Endovascular treatment for spontaneous isolated dissection of superior mesenteric artery: a Single-centre prospective study.

BACKGROUND

Endovascular stenting is a treatment option for spontaneous isolated dissection of superior mesenteric artery (SIDSMA). We aim to provide the prospective short-term data of the endovascular treatment for SIDSMA.

METHODS

One hundred two patients were enrolled in the study between April 1, 2019, and March 12, 2021. The primary outcomes were primary patency and complete remodeling of SIDSMA in the first 12 months after endovascular stenting.

RESULTS

The participants had a mean age of 54.1 ± 7.7 years, and 95.1% were male. The most common symptom was abdominal pain. All patients underwent stent implantation, with a mean of 2.3 stents. The median follow-up duration was 38 (range 12–50) months. The primary patency rate was 100% at 1 month, 95.3% at 6 months, 92.9% at 12 months, and 92.9% at 36 months. All cases of restenosis occurred in the proximal portion of the superior mesenteric artery (SMA), with 83.3% (5/6) occurring within the initial 7 postoperative months. Two patients (2%) with severe stenosis required a second intervention. The complete remodeling rate was 56.9%, 73.6%, 75.9%, and 82.3% at 1, 6, 12, and 36 months, respectively. The symptom relief rate was 90.7% at 12 months and 94.6% at 36 months.

CONCLUSIONS

Endovascular treatment for SIDSMA had satisfactory short-term primary patency and complete remodeling rates, with feasible symptom relief and a low dissection recurrence rate. TRIAL REGISTRATION: This prospective single-center study was approved by our center (clinical trial registration number: NCT03916965).