Hemodynamic causes of spontaneous isolated superior mesenteric artery dissection

Background: Recently, spontaneous isolated superior mesenteric artery dissection (SISMAD) has been widely reported, and the hemodynamic causes of SISMAD have been assumed to be the same as those of aortic dissection. However, the hemodynamic causes of SISMAD are still unknown, and the relationship b...

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Main Authors: Keli Yin, BE, Li Hou, BE, Chengxin Weng, PhD, Jianjin Yue, BE, Tinghui Zheng, PhD, Ding Yuan, PhD
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:JVS-Vascular Insights
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Online Access:http://www.sciencedirect.com/science/article/pii/S2949912725000340
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author Keli Yin, BE
Li Hou, BE
Chengxin Weng, PhD
Jianjin Yue, BE
Tinghui Zheng, PhD
Ding Yuan, PhD
author_facet Keli Yin, BE
Li Hou, BE
Chengxin Weng, PhD
Jianjin Yue, BE
Tinghui Zheng, PhD
Ding Yuan, PhD
author_sort Keli Yin, BE
collection DOAJ
description Background: Recently, spontaneous isolated superior mesenteric artery dissection (SISMAD) has been widely reported, and the hemodynamic causes of SISMAD have been assumed to be the same as those of aortic dissection. However, the hemodynamic causes of SISMAD are still unknown, and the relationship between two dissections is not clear. Methods: The predissected and healthy superior mesenteric artery models were reconstructed based on computed tomography angiography of 10 patients with SISMAD and 10 healthy subjects, respectively. Then the computational fluid dynamics method was used to find the hemodynamic difference between the two groups. Results: First, the blood flow of the patients was helical at the entrance, whereas the blood flow of the healthy people was laminar; secondly, the oscillatory shear indices of the pre-SISMAD patients were significantly higher than those in healthy subjects (P < .05). Meanwhile, the SISMAD initial tear location corresponded to the high oscillatory shear index zone. Average time-averaged wall shear stress was not significantly different between the two groups (P = .42). The deviation angles of the superior mesenteric artery from the abdominal aorta in pre-SISMAD models were significantly smaller than those in healthy subjects (44.03° ± 10.25° vs 64.23° ± 9.34°, P < .01). Conclusions: Unlike the occurrence of aortic dissection, SISMAD may be due to the continuous back and forth changes of blood flow along the mainstream direction during a cardiac cycle caused by the appearance of helical flow at superior mesenteric artery entrance.
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spelling doaj-art-94fa1b69ef7f44f186b303580aff8d662025-08-20T03:47:33ZengElsevierJVS-Vascular Insights2949-91272025-01-01310021710.1016/j.jvsvi.2025.100217Hemodynamic causes of spontaneous isolated superior mesenteric artery dissectionKeli Yin, BE0Li Hou, BE1Chengxin Weng, PhD2Jianjin Yue, BE3Tinghui Zheng, PhD4Ding Yuan, PhD5Department of Mechanics &amp; Engineering, College Architecture &amp; Environment, Sichuan University, Chengdu, China; Sichuan University Yibin Park, Yibin Institute of Industrial Technology, Yibin, ChinaDay Surgery Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, ChinaDivision of Vascular Surgery, Department of general surgery, West China Hospital, Sichuan University, Chengdu, ChinaSichuan University Yibin Park, Yibin Institute of Industrial Technology, Yibin, China; Department of Civil Engineering, Sichuan University, Chengdu, ChinaDepartment of Mechanics &amp; Engineering, College Architecture &amp; Environment, Sichuan University, Chengdu, China; Sichuan University Yibin Park, Yibin Institute of Industrial Technology, Yibin, China; Med-X Center for Informatics, Sichuan University, Chengdu, ChinaDivision of Vascular Surgery, Department of general surgery, West China Hospital, Sichuan University, Chengdu, China; Med-X Center for Informatics, Sichuan University, Chengdu, China; Department of General Surgery 1 (Hepato-Pancreato-Biliary Surgery &amp; Vascular Surgery), West China Tianfu Hospital, Sichuan University, Chengdu, China; Correspondence: Ding Yuan, PhD, Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, ChinaBackground: Recently, spontaneous isolated superior mesenteric artery dissection (SISMAD) has been widely reported, and the hemodynamic causes of SISMAD have been assumed to be the same as those of aortic dissection. However, the hemodynamic causes of SISMAD are still unknown, and the relationship between two dissections is not clear. Methods: The predissected and healthy superior mesenteric artery models were reconstructed based on computed tomography angiography of 10 patients with SISMAD and 10 healthy subjects, respectively. Then the computational fluid dynamics method was used to find the hemodynamic difference between the two groups. Results: First, the blood flow of the patients was helical at the entrance, whereas the blood flow of the healthy people was laminar; secondly, the oscillatory shear indices of the pre-SISMAD patients were significantly higher than those in healthy subjects (P < .05). Meanwhile, the SISMAD initial tear location corresponded to the high oscillatory shear index zone. Average time-averaged wall shear stress was not significantly different between the two groups (P = .42). The deviation angles of the superior mesenteric artery from the abdominal aorta in pre-SISMAD models were significantly smaller than those in healthy subjects (44.03° ± 10.25° vs 64.23° ± 9.34°, P < .01). Conclusions: Unlike the occurrence of aortic dissection, SISMAD may be due to the continuous back and forth changes of blood flow along the mainstream direction during a cardiac cycle caused by the appearance of helical flow at superior mesenteric artery entrance.http://www.sciencedirect.com/science/article/pii/S2949912725000340Superior mesenteric arteryIsolated dissectionHemodynamicCFDSISMADTAWSS
spellingShingle Keli Yin, BE
Li Hou, BE
Chengxin Weng, PhD
Jianjin Yue, BE
Tinghui Zheng, PhD
Ding Yuan, PhD
Hemodynamic causes of spontaneous isolated superior mesenteric artery dissection
JVS-Vascular Insights
Superior mesenteric artery
Isolated dissection
Hemodynamic
CFD
SISMAD
TAWSS
title Hemodynamic causes of spontaneous isolated superior mesenteric artery dissection
title_full Hemodynamic causes of spontaneous isolated superior mesenteric artery dissection
title_fullStr Hemodynamic causes of spontaneous isolated superior mesenteric artery dissection
title_full_unstemmed Hemodynamic causes of spontaneous isolated superior mesenteric artery dissection
title_short Hemodynamic causes of spontaneous isolated superior mesenteric artery dissection
title_sort hemodynamic causes of spontaneous isolated superior mesenteric artery dissection
topic Superior mesenteric artery
Isolated dissection
Hemodynamic
CFD
SISMAD
TAWSS
url http://www.sciencedirect.com/science/article/pii/S2949912725000340
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