11
Superior Mesenteric Artery Aneurysm (SMAA)
Recommendation
Grade/
LOE
1. Diagnosis and evaluation
1.1 In patients with SMAA, we recommend CTA as the diagnostic tool of
choice.
1-B
1.2 We recommend mesenteric angiography to delineate anatomy in
preoperative planning for SMAA repair.
1-B
2. Size criteria for invasive intervention (true and false aneurysms)
2.1 We recommend repair of all SMAAs and pseudoaneurysms as soon as
the diagnosis is made regardless of size.
1-A
2.2 We suggest careful observation of SMAA because of dissection unless
refractory symptoms develop.
2-B
3. Treatment options
3.1 We recommend an endovascular-first approach to all SMAAs if it is
anatomically feasible.
1-B
4. Screening for concomitant aneurysm
4.1 We suggest abdominal axial imaging to screen for concomitant
intraabdominal aneurysms in patients who did not have CTA at the
time of diagnosis.
2-B
5. Follow-up and surveillance
5.1 We suggest annual CTA to observe postsurgical patients. 2-B
