[Segmental mediolytic arteriopathy (SMA) of central, visceral and peripheral vessels]

Dtsch Med Wochenschr. 2010 Apr;135(15):745-9. doi: 10.1055/s-0030-1251927. Epub 2010 Apr 6.
[Article in German]

Abstract

History and clinical findings: A 27-year-old man had been admitted to hospital with acute neurological defects involving his legs and urinary system. An intervertebral disk was removed surgically, because a herniation had been suspected. But symptoms increased postoperatively. Further imaging showed a ruptured aneurysm of the internal iliac artery which was treated with coil embolization.

Investigations: Further diagnostic tests excluded hematological, rheumatic and endocrinological causes for the development of the aneurysm. Genetic differentiation was normal. Imaging then demonstrated "string of beads" small aneurysms of intra- and extracerebral, renal, visceral and peripheral arteries.

Treatment and course: During the past three years the patient had repeated ruptures of the intra-abdominal arterial aneurysms for which coil embolization and bypass grafting were performed, also to prevent further ruptures.

Conclusions: Segmental mediolytic arteriopathy is a rare condition requiring careful imaging and histological tests for its diagnosis and acute surgical treatment.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adult
  • Aneurysm, Ruptured / diagnosis*
  • Aneurysm, Ruptured / pathology
  • Aneurysm, Ruptured / therapy
  • Angiography
  • Aortic Aneurysm, Abdominal / diagnosis
  • Aortic Aneurysm, Abdominal / pathology
  • Aortic Aneurysm, Abdominal / therapy
  • Cerebral Arterial Diseases / diagnosis*
  • Cerebral Arterial Diseases / pathology
  • Cerebral Arterial Diseases / therapy
  • Diagnosis, Differential
  • Embolization, Therapeutic
  • Humans
  • Iliac Artery / pathology
  • Image Processing, Computer-Assisted
  • Imaging, Three-Dimensional
  • Intervertebral Disc Displacement / diagnosis
  • Intervertebral Disc Displacement / surgery
  • Intracranial Aneurysm / diagnosis*
  • Intracranial Aneurysm / pathology
  • Intracranial Aneurysm / therapy
  • Ischemia / diagnosis*
  • Ischemia / pathology
  • Ischemia / therapy
  • Kidney / blood supply*
  • Laparoscopy
  • Leg / blood supply
  • Lumbar Vertebrae / surgery
  • Magnetic Resonance Angiography
  • Male
  • Necrosis
  • Peripheral Vascular Diseases / diagnosis*
  • Peripheral Vascular Diseases / pathology
  • Peripheral Vascular Diseases / therapy
  • Polyradiculopathy / diagnosis
  • Polyradiculopathy / surgery
  • Postoperative Complications / diagnosis
  • Postoperative Complications / pathology
  • Postoperative Complications / therapy
  • Renal Artery / pathology
  • Tibial Arteries / pathology
  • Tomography, X-Ray Computed
  • Tunica Media* / pathology