Analysis of prognosis and predictors for spontaneous isolated superior mesenteric artery dissection

Objective To analyze the prognosis and predictive factors for patients with spontaneous isolated superior mesenteric artery (SMA) dissection. Methods A total of 147 consecutive spontaneous isolated superior mesenteric areteric dissection (SISMAD) patients from 2013 to 2017 were evaluated retrospectively. 48 clinical, radiological and laboratory potential prognostic factors were evaluated using univariate and multivariate Logistic regression analyses. Results The follow-up time was 6-66 months (31 months average) . Complete remodeling was observed in 32 patients (22%) , and the independent predictive factors were heart rate (HR=0.358, P=0.031) , alcoholism (HR=0.272, P=0.023) , SMA normal diameter (HR=2.674, P=0.047) and SMA thrombosis (HR=0.186, P=0.009) . 38 patients (26%) still have clinical symptoms and body mass index (BMI, HR=2.735, P=0.036) , initial symptoms (HR=2.534, P=0.045) and aorta-SMA angle (HR=0.418, P=0.049) were demonstrated to be significant predictive factors. The radiological and clinical prognosis were inconsistent in 89 patients and associated with initial symptoms (HR=0.288, P=0.004) and SMA normal diameter (HR=2.894, P=0.016) obviously. Conclusion The overall prognosis of SISMAD was favorable. However, the rates of complete remodeling and complete recovering of symptoms were relatively low, and the radiological and clinical prognosis were inconsistent. Key words: Superior mesenteric artery dissection; Prognosis; Predictor