Journal of Vascular Surgery Cases and Innovative Techniques (Jun 2024)

Segmental arterial mediolysis after fenestrated endovascular abdominal aortic aneurysm repair—A rare complication

  • Eric T.A. Lim, MB, ChB,
  • Andrew Gilkison, FRANZCR,
  • Hannah Elstub, FRCPA,
  • Frances Colgan, FRCR,
  • Timothy Buckenham, FRANZCR,
  • Adib Khanafer, FRCS, FRACS

Journal volume & issue
Vol. 10, no. 3
p. 101470

Abstract

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Segmental arterial mediolysis (SAM) is a rare, noninflammatory, nonatherosclerotic condition that occurs commonly in mesenteric vessels. There are no known predisposing risk factors to the development of SAM. We present a case of a 67-year-old woman who presented with abdominal pain 2 days following discharge after an elective endovascular abdominal aortic intervention. Repeat imaging 2 days after readmission showed the presence of multiple new aneurysms involving the mesenteric vasculature. She underwent attempted endovascular embolization of the largest aneurysm. The postmortem and histopathologic examinations confirmed the diagnosis of SAM.

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