• 1. Department of Vascular Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P. R. China;
  • 2. Department of General Surgery, University-Town Hospital of Chongqing Medical University, Chongqing 401331, P. R. China;
TANG Bo, Email: 300374@hospital.cqmu.edu.cn
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Objective To explore the current research status of endovascular treatment for isolated superior mesenteric artery dissection (ISMAD) so as to provide a reference for vascular surgeons and patients in selecting surgical methods. Method The recent domestic and international literature on the endovascular treatment for ISMAD was collected and summarized. Results The current endovascular treatment methods for ISMAD mainly included catheter-directed thrombolysis and stent placement. For the ISMAD patients with true intraluminal thrombus formation, true luminal occlusion, and partial embolization of branch vessels, catheter-directed thrombolysis were performed by continuously pumping urokinase locally to dissolve thrombus and improve distal blood supply. The stent placement mainly included two main types: bare stent placement and covered stent placement, both aiming to promote true lumen recanalization, false lumen thrombosis, and vascular remodeling through mechanical support and blood flow redirection. The bare stents had unique advantages such as being well-developed, offering a wide range of options, and having stable performance. However, covered stents were superior to bare stents in terms of mid-term patency rate and in-stent restenosis. Conclusions With the development of technology, endovascular treatment has become an indispensable method for ISMAD patients. Extensive multicenter case reports from both domestic and international studies have supported the safety and efficacy of endovascular treatment. Catheter-directed thrombolysis, bare stent placement, and covered stent placement offer targeted solutions for various types of ISMAD patients, providing more minimally invasive and effective treatment.