Abstract
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.
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Acknowledgements
We thank Jian Wang, Qiao Chen and Weixing Zhuang, for their help with data analysis; and Megan Griffiths, scientific writer, Cleveland, Ohio, USA, for her help with revising the manuscript.
Funding
This study was supported by the China Postdoctoral Science Foundation (2018M630582), the Natural Science Foundation of China (81401498), and the Jiangsu Provincial Medical Youth Talent (QNRC2016270). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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Hang, C., Chen, W., Su, H. et al. Distal Edge Stenosis After Stent Placement for Isolated Superior Mesenteric Artery Dissection: Mechanisms and Risk Factor Analysis. Cardiovasc Intervent Radiol 42, 1095–1101 (2019). https://doi.org/10.1007/s00270-019-02244-3
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DOI: https://doi.org/10.1007/s00270-019-02244-3