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

Schönefeld E, Völker W, Torsello G

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.

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