Access selection in endovascular treatment of spontaneous isolated superior mesenteric artery dissection: A single-center retrospective case series
Feng Zhou, Jiangwei ZuoBACKGROUND:
Spontaneous isolated superior mesenteric artery dissection (SISMAD) is a rare visceral vascular lesion with nonspecific clinical manifestations. Published descriptions of access selection in the endovascular treatment of SISMAD remain limited.
AIMS AND OBJECTIVES:
This study describes the access-selection practices and observed outcomes of seven patients treated at a single center.
MATERIALS AND METHODS:
The clinical data of seven patients diagnosed with SISMAD and treated endovascularly at The Second People’s Hospital of Nanning from January 2020 to January 2026 were retrospectively reviewed. Access was selected according to the preoperative clinical assessment of the SMA-aortic angle, entry-tear location, and access-vessel condition (brachial access,
RESULTS:
Endovascular treatment was completed in all seven patients; all arterial punctures succeeded on the first attempt, and true-lumen super-selection was achieved in all patients. Sixteen stents were implanted (mean, 2.29 stents per patient). Abdominal pain was relieved within 3–5 days after the procedure, and the mean hospital stay was 10.28 days; no perioperative complications were recorded. Follow-up duration ranged from 1 to 60 months (median, 3 months). Follow-up computed tomographic angiography was available for six patients and showed a patent true lumen with a thrombosed false lumen and no stent displacement or true-lumen restenosis. One patient was followed by telephone only for 2 months and reported no recurrence of symptoms.
CONCLUSION:
Anatomy-informed access selection was technically feasible in this seven-patient retrospective case series, with no perioperative complications recorded. Further prospective studies with standardized assessment and follow-up are needed.