Medical treatment

Endovascular therapy versus medical therapy for isolated spontaneous superior mesenteric artery dissection

key message

There is not enough evidence to compare the benefits and harms of the two main treatment options for people with spontaneous mesenteric artery dissection (SIDSMA).

Why is this question important?

Blood vessels are made up of different layers. If one of these layers tears or ruptures, blood can flow between the layers, pulling the layers apart and creating two channels for the blood to flow through, which prevents the blood from delivering oxygen and nutrients. Spontaneous isolated superior mesenteric artery dissection (SIDSMA) occurs after a rupture of one of the major blood vessels in the abdomen (stomach area), called the superior mesenteric artery, occurs for no clear reason and in no other main vessel. People may have no symptoms or have abdominal pain, feeling unwell, vomiting, diarrhea, or blood in the stool.

There are two main treatment options for people with AIDSSMA. The first is medical treatment, where people receive nutrients through a line directly into the blood. This means that the stomach and intestines (where food is digested) don’t need as much blood. This gives ruptured vessels time to recover. The second option is endovascular therapy, where a small incision is made in the groin area or elbow pit and a small tube (stent) is placed in the blood vessel to seal the rupture and restore normal blood flow. . Medical treatment is not always effective, and the stent may not continue to maintain normal blood flow for a long time after endovascular treatment.

It is important to know the pros and cons of both options so that doctors and people with AIDSSMA can make the best decision about treatment.

What have we done?

We searched the literature for randomized controlled trials comparing endovascular therapy with medical treatment for the management of AIDSSMA. In randomized controlled trials, the treatments people receive are decided at random, and these provide the most reliable evidence about treatment effects.

What did we find?

We found no studies comparing endovascular therapy with medical treatment.

How sure are we of the evidence?

There is a lack of evidence to help answer this question. High-quality studies are needed to help inform the best treatment options.

How up-to-date is this evidence?

The evidence is current to August 3, 2021.