Clinical Experience of Symptomatic Spontaneous Isolated Splanchnic Artery Dissection / 대한혈관외과학회지

ABSTRACT

PURPOSE: Symptomatic spontaneous isolated splanchnic artery dissection (SSISAD) is a rare disease entity. The treatment guideline for SSISAD has not been established. Isolated dissection of splanchnic artery can be clinically asymptomatic or symptomatic. Symptomatic dissection is more important because it can indicate ischemia of abdominal organ. METHODS: A retrospective study was conducted on 15 consecutive patients (mean age, 47.0 years; male, 87%) with SSISAD from January 2006 to July 2013. Each patient had acute onset abdominal pain and was diagnosed with SSISAD by abdominal-pelvic computed tomography. RESULTS: Median follow-up duration was 14.5+/-27.7 months (range, 1 to 79 months). Splanchnic arterial dissection involved celiac artery in three patients and superior mesentery artery in 12 patients. Conservative management (including bowel rest, hypertension medication, anticoagulation, and prophylactic antibiotics) was done in 14 patients. Endovascular treatment with stent insertion was performed in one patient. We experienced favorable clinical outcomes with SSISAD, even though one case needed endovascular treatment. CONCLUSION: Conservative management and selective revascularization could be a treatment option in patients with SSISAD.