Segmental arterial mediolysis (SAM): Systematic review and analysis of 143 cases
| Autor: | Gopika Hari, Sydney L Olson, Nedaa Skeik, Mary L Pavia |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Abdominal pain medicine.medical_specialty Aortic Rupture Diagnosis Differential Aneurysm Predictive Value of Tests Risk Factors Abdomen Occlusion medicine Humans Aged Aged 80 and over Arterial dissection business.industry Mortality rate Middle Aged medicine.disease Aortic Dissection Dissection Stenosis Treatment Outcome Etiology Female Radiology medicine.symptom Cardiology and Cardiovascular Medicine business Aortic Aneurysm Abdominal |
| Zdroj: | Vascular Medicine. 24:549-563 |
| ISSN: | 1477-0377 1358-863X |
| Popis: | Segmental arterial mediolysis (SAM) is a rare but serious nonatherosclerotic, noninflammatory vasculopathy of unknown etiology that often results in dissection, aneurysm, occlusion, or stenosis of, primarily, the abdominal arteries. Current literature lacks consensus on diagnostic criteria and management options for SAM. This review summarizes 143 cases and aims to advance appropriate recognition and management of SAM. Literature review of all relevant SAM case studies from 2005 to 2018 yielded 126 individual SAM cases from 66 reports. We identified 17 additional SAM cases from our center, bringing our analysis to 143 patients. Patients with SAM were most commonly men (68%) in their 60s. Hypertension (43%), tobacco use (12%), and hyperlipidemia (12%) were common comorbidities. Abdominal pain (80%) and intraabdominal bleeding (50%) were the most common presenting symptoms. Computed tomography was the most frequently used imaging method (78%), and histology was available in 44% of cases. The most commonly affected vessels were the superior mesenteric (53%), hepatic (45%), celiac (36%), renal (26%), and splenic (25%) arteries with aneurysm (76%), dissection (61%), and arterial rupture (46%). Treatments included coil embolization (28%), abdominal organ surgery (24%), open arterial repair (21%), and medical management (20%). Case-specific treatment modalities yielded symptom relief in the vast majority (91%) of patients, with a mortality rate of 7%. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|