Superior mesenteric artery dissection: Rationale for a conservative approach in selected patients - A case report

The superior mesenteric artery (SMA) is an uncommon location for spontaneou s peripheral arterial dissections. In the past, most symptomatic SMA dissec tions were treated surgically. However, the authors recently treated a heal thy 40-year-old man who experienced a symptomatic SMA dissection with antic oagulation therapy alone. The patient had bilateral internal carotid artery (ICA) dissections in the past that were also managed in a conservative fas hion. To their knowledge, this is the first patient reported in the literat ure with both ICA and SMA dissections, In addition, he is one of only a few patients with an SMA dissection who was successfully treated without surgi cal intervention. From our experience with this patient and a review of the literature, we believe that a trial of anticoagulation therapy is warrante d in all patients with uncomplicated, symptomatic SMA dissections.