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HOME > J Trauma Inj > Volume 28(4); 2015 > Article
Endovascular Stent Placement in a Patient with a Posttraumatic Isolated Superior Mesenteric Artery Dissection with Focally Progressing Dissecting Aneurysms and a Severely Compressed True Lumen
Young Kyu Kim, Kyu Hee Her, Seung Hyoung Kim, Kwangsik Kim
Journal of Trauma and Injury 2015;28(4):266-271
DOI: https://doi.org/10.20408/jti.2015.28.4.266
Published online: December 31, 2015
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1Department of Surgery, Jeju National University School of Medicine, Jeju-si, Republic of Korea. herkh@jejunu.ac.kr
2Department of Radiology, Jeju National University School of Medicine, Jeju-si, Republic of Korea.
Received: 12 October 2014   • Revised: 15 November 2015   • Accepted: 7 December 2015

Reports on a posttraumatic isolated superior mesenteric artery (SMA) dissection are rare. Recently, endovascular stent placement via percutaneous access, instead of vascular surgery, has been widely accepted as the initial treatment for a patient with an isolated SMA dissection or its complications. A 60-year-old female patient was transferred to our hospital due to an isolated SMA dissection after a car accident. The SMA dissection was 8.5 cm in length, and it involved the true lumen, which was severely compressed by the thrombosed false lumen. The patient was closely observed because she did not complain of any specific visceral pain. On the seventh hospital day, she underwent computed tomography (CT) to decide on a further treatment plan, irrespective of the presence of the abdominal symptom. The findings of the follow-up CT showed no difference compared to those of the previous CT. She was discharged with anticoagulants. One month later, the follow-up CT revealed focally progressing dissecting aneurysms in the false lumen of the dissected SMA and a more severely compressed true lumen. Two self-expandable metallic stents were successfully placed in the true lumen of the dissected SMA, covering two aneurysmal lesions. Herein, we report a successful endovascular treatment with stent placement for treating focally progressing dissecting aneurysms and a severely compressed true lumen in a patient with a posttraumatic isolated SMA dissection.

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