Yekai Weng, Jie Sun, Dehai Lang
The study aims to analyze the safety and effectiveness of endovascular treatment for complicated symptomatic spontaneous isolated superior mesenteric artery dissection (SISMAD). This is a retrospective study of 93 patients undergoing endovascular treatment for symptomatic SISMAD from June 2019 to June 2024. The primary outcomes were the cumulative complete remodeling (ie, true lumen dilated with false lumen disappeared) rate and dissection-related mortality. Secondary outcomes included re-intervention, bare stent patency, and adverse events. Patients (n = 93; mean age, 58 years; 91.4% men) were included in the study. Abdominal pain was the most common symptom (94.6%). The cumulative complete remodeling rates at 6, 12, 36, and 60 months postoperatively were 71.0%, 78.2%, 86.3%, and 86.3%, respectively. In the cases treated with stent assisted coiling, 100% patients achieved complete remodeling, compared with 84.1% in the cases treated with stent alone, with statistically significant difference ( P < .001). The rate of adverse events and early re-intervention was 6.5% (6/93) and 5.4% (5/93). The median follow-up time was 27 months (range 6-64), and there was 1 case of late re-intervention, 1 case of stent occlusion, and no dissection-related deaths. Endovascular treatment showed a satisfactory outcome in treating symptomatic SISMAD, with a good cumulative complete remodeling rate.