Segmental arterial mediolysis: Abdominal imaging of and disease course in 111 patients

Sailendra Naidu, Christine O. Menias, Rahmi Oklu, Robert S. Hines, Kinan Alhalabi, Gerges Makar, Fadi E. Shamoun, Stanislav Henkin, Robert D. McBane

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of this study is to identify the imaging characteristics of segmental arterial mediolysis (SAM) at presentation and establish the longitudinal course of disease. MATERIALS AND METHODS. We retrospectively identifed patients with SAM at a single institution from 2000 through 2015. Diagnosis was based on published guidelines with multidisciplinary consensus. Imaging studies obtained at initial evaluation were reviewed to evaluate imaging fndings and vascular territory distribution. All subsequent follow-up imaging studies were reviewed to assess for progression, stability, or regression. RESULTS. We identifed 111 patients (79 men and 32 women; median age, 51 years) who met the diagnostic criteria for SAM. Abdominal pain was the most common presentation (74%), followed by flank pain (21%). SAM most commonly affected the renal arteries (47%), superior mesenteric artery (46%), celiac trunk (46%), hepatic artery (23%), iliac arteries (18%), and splenic artery (14%). The most common imaging fndings were dissection (86%), aneurysm (57%), beading or webs (28%), occlusion (19%), and a rind or wall thickening (15%). The 247 available follow-up imaging studies for 97 patients (median follow-up, 12 months) showed progression in 19 patients (20%), with either stability or regression observed in the remaining patients. CONCLUSION. SAM most commonly affects the renal arteries, superior mesenteric artery, and celiac artery. Dissections and aneurysms are the most common imaging fndings. Follow-up imaging studies show stability or regression in most patients.

Original languageEnglish (US)
Pages (from-to)899-905
Number of pages7
JournalAmerican Journal of Roentgenology
Volume210
Issue number4
DOIs
StatePublished - Apr 1 2018

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Superior Mesenteric Artery
Renal Artery
Aneurysm
Dissection
Celiac Artery
Flank Pain
Splenic Artery
Iliac Artery
Hepatic Artery
Abdomen
Abdominal Pain
Blood Vessels
Guidelines

Keywords

  • Aneurysm
  • Dissection
  • Hemorrhage
  • Segmental arterial mediolysis
  • Vasculopathy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Segmental arterial mediolysis : Abdominal imaging of and disease course in 111 patients. / Naidu, Sailendra; Menias, Christine O.; Oklu, Rahmi; Hines, Robert S.; Alhalabi, Kinan; Makar, Gerges; Shamoun, Fadi E.; Henkin, Stanislav; McBane, Robert D.

In: American Journal of Roentgenology, Vol. 210, No. 4, 01.04.2018, p. 899-905.

Research output: Contribution to journalArticle

Naidu, S, Menias, CO, Oklu, R, Hines, RS, Alhalabi, K, Makar, G, Shamoun, FE, Henkin, S & McBane, RD 2018, 'Segmental arterial mediolysis: Abdominal imaging of and disease course in 111 patients', American Journal of Roentgenology, vol. 210, no. 4, pp. 899-905. https://doi.org/10.2214/AJR.17.18309
Naidu, Sailendra ; Menias, Christine O. ; Oklu, Rahmi ; Hines, Robert S. ; Alhalabi, Kinan ; Makar, Gerges ; Shamoun, Fadi E. ; Henkin, Stanislav ; McBane, Robert D. / Segmental arterial mediolysis : Abdominal imaging of and disease course in 111 patients. In: American Journal of Roentgenology. 2018 ; Vol. 210, No. 4. pp. 899-905.
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AU - Menias, Christine O.

AU - Oklu, Rahmi

AU - Hines, Robert S.

AU - Alhalabi, Kinan

AU - Makar, Gerges

AU - Shamoun, Fadi E.

AU - Henkin, Stanislav

AU - McBane, Robert D.

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N2 - OBJECTIVE. The purpose of this study is to identify the imaging characteristics of segmental arterial mediolysis (SAM) at presentation and establish the longitudinal course of disease. MATERIALS AND METHODS. We retrospectively identifed patients with SAM at a single institution from 2000 through 2015. Diagnosis was based on published guidelines with multidisciplinary consensus. Imaging studies obtained at initial evaluation were reviewed to evaluate imaging fndings and vascular territory distribution. All subsequent follow-up imaging studies were reviewed to assess for progression, stability, or regression. RESULTS. We identifed 111 patients (79 men and 32 women; median age, 51 years) who met the diagnostic criteria for SAM. Abdominal pain was the most common presentation (74%), followed by flank pain (21%). SAM most commonly affected the renal arteries (47%), superior mesenteric artery (46%), celiac trunk (46%), hepatic artery (23%), iliac arteries (18%), and splenic artery (14%). The most common imaging fndings were dissection (86%), aneurysm (57%), beading or webs (28%), occlusion (19%), and a rind or wall thickening (15%). The 247 available follow-up imaging studies for 97 patients (median follow-up, 12 months) showed progression in 19 patients (20%), with either stability or regression observed in the remaining patients. CONCLUSION. SAM most commonly affects the renal arteries, superior mesenteric artery, and celiac artery. Dissections and aneurysms are the most common imaging fndings. Follow-up imaging studies show stability or regression in most patients.

AB - OBJECTIVE. The purpose of this study is to identify the imaging characteristics of segmental arterial mediolysis (SAM) at presentation and establish the longitudinal course of disease. MATERIALS AND METHODS. We retrospectively identifed patients with SAM at a single institution from 2000 through 2015. Diagnosis was based on published guidelines with multidisciplinary consensus. Imaging studies obtained at initial evaluation were reviewed to evaluate imaging fndings and vascular territory distribution. All subsequent follow-up imaging studies were reviewed to assess for progression, stability, or regression. RESULTS. We identifed 111 patients (79 men and 32 women; median age, 51 years) who met the diagnostic criteria for SAM. Abdominal pain was the most common presentation (74%), followed by flank pain (21%). SAM most commonly affected the renal arteries (47%), superior mesenteric artery (46%), celiac trunk (46%), hepatic artery (23%), iliac arteries (18%), and splenic artery (14%). The most common imaging fndings were dissection (86%), aneurysm (57%), beading or webs (28%), occlusion (19%), and a rind or wall thickening (15%). The 247 available follow-up imaging studies for 97 patients (median follow-up, 12 months) showed progression in 19 patients (20%), with either stability or regression observed in the remaining patients. CONCLUSION. SAM most commonly affects the renal arteries, superior mesenteric artery, and celiac artery. Dissections and aneurysms are the most common imaging fndings. Follow-up imaging studies show stability or regression in most patients.

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KW - Vasculopathy

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