Clinical studySegmental Arterial Mediolysis: Clinical and Imaging Features at Presentation and during Follow-up
Section snippets
Materials and Methods
This retrospective study was approved by the institutional review board and was compliant with the Health Insurance Portability and Accountability Act. The review board waived the requirement to obtain informed consent from the study subjects for inclusion in this study.
Clinical Presentation
Abdominal pain was the most common clinical presentation (Table 2). Seven of the 14 patients (50%) presented with abdominal pain, four with an acute abdomen, and three with chronic abdominal pain. Other symptoms included flank pain, chest pain, headache, stroke with hemiparesis, and suprapubic fullness in one patient each. Two patients were asymptomatic: the imaging findings characteristic of SAM were identified on imaging performed for follow-up of renal cell cancer in one patient and
Discussion
The incidence of SAM is unknown but is probably underestimated (7). The disease affects middle-aged and elderly patients with no male or female predilection. The splanchnic vessels are most commonly involved. However, involvement of the carotid, renal, intracranial, and iliac arteries has been reported (5). The pattern of vascular involvement varies with age; cerebral vasculature is more commonly involved in young patients (8), whereas the coronary arteries are commonly involved in neonates and
References (25)
- et al.
Spontaneous dissection with rupture of the superior mesenteric artery from segmental arterial mediolysis
J Vasc Surg
(2011) Necrosis in the coronary arteries of newborn infants
Am Heart J
(1949)Segmental arterial mediolysis: course, sequelae, prognosis, and pathologic-radiologic correlation
Cardiovasc Pathol
(2009)- et al.
Reconstructive surgery for segmental arterial mediolysis involving both the internal carotid artery and visceral arteries
J Vasc Surg
(2006) - et al.
Segmental arterial mediolysis: unrecognized cases culled from cases of ruptured aneurysm of abdominal visceral arteries reported in the Japanese literature
Pathol Res Pract
(2007) - et al.
Coil embolization of segmental arterial mediolysis of the hepatic artery
J Vasc Interv Radiol
(2000) - et al.
Segmental arterial mediolysis: angioplasty of bilateral renal artery stenoses with 2-year imaging follow-up
J Vasc Interv Radiol
(2004) - et al.
Successful treatment tailored to each splanchnic arterial lesion due to segmental arterial mediolysis (SAM): report of a case
J Vasc Surg
(2008) - et al.
Segmental arterial mediolysis: a precursor to fibromuscular dysplasia?
Mod Pathol
(1995) Segmental mediolytic arteritisNot an arteritis but a variant of arterial fibromuscular dysplasia
Arch Pathol Lab Med
(1992)
Segmental arterial mediolysis with accompanying venous angiopathy: a clinical pathologic review, report of 3 new cases, and comments on the role of endothelin-1 in its pathogenesis
Int J Surg Pathol
Segmental mediolytic arteritis: a clinical pathologic study
Lab Invest
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None of the authors have identified a conflict of interest.