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. 2019 Aug 13;44:33–37. doi: 10.1016/j.ejvssr.2019.07.002

Table 1.

Literature review of endovascular treatment of isolated spontaneous SMA dissecting aneurysms over the past five years

Paper Year of publication Type of pathology Modality of treatment
Wall ML, Newman JE, Slaney PL, et al. Isolated dissecting aneurysms of the abdominal aorta and the superior mesenteric artery. A case report and literature review. Ann Vasc Surg 2014; 28:1937.e5–1937.e8 2014 Dissecting aneurysm of SMA Endovascular management (infrarenal aortoiliac grafting in this case) has high success rate.
Tkalčić L, Budiselić B, Kovačević M, et al. Endovascular management of superior mesenteric artery (sma) aneurysm - adequate access is essential for success - case report. Pol J Radiol 2017; 82:379–83. 2017 2.2 cm SMA aneurysm without dissection Stenting with covered stents
Björck M, Koelemay M, Acosta S, et al. Editor's Choice – Management of the diseases of mesenteric arteries and veins. Eur J Vasc Endovasc Surg 2017; 53:460–510. 2017 SMA aneurysms Asymptomatic aneurysms less than 25mm can be observed (except women of child-bearing age, recipients of abdominal organ transplant, or aneurysms of pancreaticoduodenal and gastroduodenal arcades or hepatic artery)
If intervention is indicated, open, laparoscopic, or endovascular repairs can be considered. No modalities are proven to be superior than others
Open or laparoscopic repair: resection and end to end anastomosis, re-implantation, graft interposition, or simple ligation
Endovascular repair: implantation of a covered or flow diverting stents, embolisation with coils or glue, percutaneous thrombin injection
Björck M, Koelemay M, Acosta S, et al. Editor's Choice – management of the diseases of mesenteric arteries and veins. Eur J Vasc Endovasc Surg 2017; 53:460–510 2017 SMA dissections Asymptomatic patients can be treated by medical therapy (antiplatelet therapy, control of hypertension)
Symptomatic patients can be treated by endovascular method most often by stenting
If endovascular treatment fails, surgical bypass, intimectomy, thrombectomy, or patch angioplasty can be performed
Hussein D, Ashraf A, Ahmed S, Habeeb K. Isolated superior mesenteric artery dissection: a case Report and Literature Review. Gastroenterology Res 2018; 11:374–8 2018 SMA dissection Conservative management and anticoagulation, endovascular stenting, open surgical repair
Waqas U, Maryam M, Hafez MA MD, et al. Diagnosis and management of isolated superior mesenteric artery dissection: a systematic review and meta-analysis. Korean Circ J 2019; 49:400–18 2019 SMA dissection Conservative or endovascular management can be used in most patients with lower costs, morbidity and mortality. Surgical management should be reserved for complicated cases or indications like vessel rupture or bowel infarction

SMA = superior mesenteric artery.