Study of 37 Cases of Isolated Dissection of a Visceral Artery

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  • 孤立性内臓動脈解離37例の検討
  • コリツセイ ナイゾウ ドウミャク カイリ 37レイ ノ ケントウ

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<p>Isolated visceral artery dissection (IVAD) is a relatively rare disease, but the number of reports is increasing due to improvements in diagnostic imaging techniques. Owing to the accumulation of reports, a clinical practice guideline has been published by the European Society of Vascular Surgery (ESVS), but there are still many unknowns regarding the cause, natural history, gender distribution, prognosis and treatment of IVAD. We examined the data of 37 cases, including data pertaining to the backgrounds, symptoms, diagnostic modalities used, and treatment. The 37 patients included 34 male and 3 female patients, with an average age of 58.5 years. Among the patients, 25 with acute IVAD complained of acute abdominal pain, although in some patients who presented to the emergency room, the diagnosis was made after examination for back pain or suspected ileus. The remaining 12 cases were diagnosed incidentally. Conservative treatment with antihypertensive and/or antithrombotic therapy with antihypertensive and/or antithrombotic agents was administered in 71.4％ of the patients, while the remaining 28.6％ patients received invasive treatment. There was only one fatal case of intestinal ischemia associated with SMA dissection. The prognosis of IVAD is, in general, good, but it is important not to overlook cases of intestinal ischemia and to provide timely and appropriate invasive treatment where needed.</p>

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