Isolated dissecting aneurysm of the superior mesenteric artery: intravascular ultrasound (IVUS) images.

ABSTRACT

A case of the isolated dissection of the superior mesenteric artery (SMA) is presented, with the intravascular ultrasound (IVUS) images. Abdominal computed tomography revealed an intraluminal hematoma in the proximal portion of the SMA in a 57-year-old man complaining of persistent abdominal pain. Selective angiography showed narrowing of the SMA. The most compatible diagnosis was a dissection of the SMA, however, the possibility of SMA thromboembolisms could not be denied. Transcatheter suction removal of thrombi would be reconmmended for SMA thromboembolisms, however, intraarterial suction should be avoided so as not to injure the internal surface of the intima in cases of dissection of SMA. The IVUS images clearly demonstrated the condition of the true and false lumen of the dissecting region in detail. Transluminal balloon angioplasty of the true lumen and systemic anticoagulation treatment resulted in uneventful recovery. Demonstration of the exact condition in the dissecting region using IVUS is useful for selecting therapeutic strategies in cases with isolated dissecting aneurysm of the SMA.