Vasc Spec Int.  2019 Sep;35(3):174-179. 10.5758/vsi.2019.35.3.174.

Segmental Arterial Mediolysis: A Case Study and Review of the Literature in Accurate Diagnosis and Management

• Tan R

• KMID: 2460016
• DOI: http://doi.org/10.5758/vsi.2019.35.3.174

Abstract

Segmental arterial mediolysis (SAM) is a rare noninflammatory, nonarteriosclerotic arteriopathy of an unknown etiology. It most commonly affects the medium-sized vessels of the abdomen and is characterized by the disruption of the arterial medial layer. Although histological confirmation remains the gold standard in diagnosis, the use of computed tomography angiography (CTA) has greatly aided the diagnosis and surveillance of SAM. Given its rarity and angiographic similarities to other vasculopathies, the diagnosis of SAM can be challenging and is often missed. We describe the case of a 46-year-old male patient who presented to our institution with abdominal pain and multiple foci of intra-abdominal arterial dissections on CTA. We report the acute management via endovascular intervention and review the literature with respect to the diagnosis and management of this rare condition. SAM remains an uncommon yet significant disease process requiring prompt and accurate diagnosis. Initiation of immediate treatment is crucial, given the knowledge gap about its natural progression.

Keyword

Segmental arterial mediolysis; Endovascular; Dissection

MeSH Terms

Abdomen
Abdominal Pain
Angiography
Diagnosis*
Humans
Male
Middle Aged