PURPOSE To analyze factors potentially associated with the occurrence of distal edge stenosis after stent placement for isolated superior mesenteric artery dissection (ISMAD). MATERIALS AND METHODS Cases of consecutive patients who were diagnosed with spontaneous ISMAD between February 2010 and July 2018 were retrospectively identified. Of the 123 cases identified, 45 patients (42 men; three women) underwent endovascular stent placement and were included in the study. Univariate and multivariate analyses were used to assess factors potentially associated with distal edge stenosis. RESULTS The technical success rate among study patients was 100%. During 26.7 ± 17.3 months of follow-up, CT angiography demonstrated good distal edge patency in 25 patients (55.6%) and evidence of distal edge stenosis in 20 patients (44.4%). In univariate analysis, stent length (odds radio [OR] 1.03; 95% confidence interval [CI] 1.01, 1.06; P = .02), stent-to-vessel (S/V) diameter ratio (OR 2.27; 95% CI 1.35, 3.82; P < .01), and angulation at the distal edge (OR 1.05; 95% CI 1.00, 1.10; P =.03) were significantly associated with distal edge stenosis; only S/V diameter ratio (OR 3.36; 95% CI 1.41, 7.99; P < .01) and angulation at the distal edge (OR 1.12; 95% CI 1.01, 1.23; P =.03) retained this significance in multivariate analysis. CONCLUSIONS Distal edge stenosis after stent placement for ISMAD is common. S/V diameter ratio and angulation at the distal edge are independent risk factors for distal edge stenosis in patients with ISMAD who undergo stent placement.

中文翻译：

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远端肠系膜上动脉夹层支架置入术后远端边缘狭窄：机制和危险因素分析。

目的分析支架置入后肠系膜上动脉分离术（ISMAD）与远端边缘狭窄发生的潜在相关因素。材料与方法回顾性分析2010年2月至2018年7月间连续被诊断为自发ISMAD的连续病例。在确定的123例病例中，有45例（42例男性； 3例女性）接受了血管内支架置入并被纳入研究。单因素和多因素分析用于评估与远端边缘狭窄相关的潜在因素。结果研究患者的技术成功率为100％。在26.7±17.3个月的随访中，CT血管造影显示25例患者（55.6％）的远端边缘通畅性良好，20例患者（44.4％）的远端边缘狭窄的证据。在单变量分析中，支架长度（单射比[OR] 1.03； 95％置信区间[CI] 1.01、1.06； P = .02），支架与血管（S / V）直径比（OR 2.27； 95％CI 1.35、3.82； P <.01），远端边缘的角度（OR 1.05； 95％CI 1.00，1.10； P = .03）与远端边缘狭窄显着相关；在多变量分析中，只有S / V直径比（OR 3.36; 95％CI 1.41，7.99; P <.01）和远端边缘成角度（OR 1.12; 95％CI 1.01，1.23; P = .03）保留了这一意义。 。结论ISMAD支架置入后远端边缘狭窄是常见的。S / V直径比和远端边缘的角度是接受支架置入的ISMAD患者远端边缘狭窄的独立危险因素。35，3.82; P <.01），远端边缘的角度（OR 1.05； 95％CI 1.00，1.10； P = .03）与远端边缘狭窄显着相关；在多变量分析中，只有S / V直径比（OR 3.36; 95％CI 1.41，7.99; P <.01）和远端边缘成角度（OR 1.12; 95％CI 1.01，1.23; P = .03）保留了这一意义。 。结论ISMAD支架置入后远端边缘狭窄是常见的。S / V直径比和远端边缘的角度是接受支架置入的ISMAD患者远端边缘狭窄的独立危险因素。35，3.82; P <.01）和远端边缘的角度（OR 1.05； 95％CI 1.00，1.10； P = .03）与远端边缘狭窄显着相关。在多变量分析中，只有S / V直径比（OR 3.36; 95％CI 1.41，7.99; P <.01）和远端边缘成角度（OR 1.12; 95％CI 1.01，1.23; P = .03）保留了这一意义。 。结论ISMAD支架置入后远端边缘狭窄是常见的。S / V直径比和远端边缘的角度是接受支架置入的ISMAD患者远端边缘狭窄的独立危险因素。03）在多变量分析中保留了这一意义。结论ISMAD支架置入后远端边缘狭窄是常见的。S / V直径比和远端边缘的角度是接受支架置入的ISMAD患者远端边缘狭窄的独立危险因素。03）在多变量分析中保留了这一意义。结论ISMAD支架置入后远端边缘狭窄是常见的。S / V直径比和远端边缘的角度是接受支架置入的ISMAD患者远端边缘狭窄的独立危险因素。