Endovascular Treatment of Chronic Mesenteric Ischemia: Results in 14 Patients
- 149 Downloads
We evaluated immediate and long-term results of percutaneous transluminal angioplasty (PTA) and stent placement to treat stenotic and occluded arteries in patients with chronic mesenteric ischemia. Fourteen patients were treated by 3 exclusive celiac artery (CA) PTAs (2 stentings), 3 cases with both Superior Mesenteric Artery (SMA) and CA angioplasties, and 8 exclusive SMA angioplasties (3 stentings). Eleven patients had atheromatous stenoses with one case of an early onset atheroma in an HIV patient with antiphospholipid syndrome. The other etiologies of mesenteric arterial lesions were Takayashu arteritis (2 cases) and a postradiation stenoses (1 case). Technical success was achieved in all cases. Two major complications were observed: one hematoma and one false aneurysm occurring at the brachial puncture site (14.3%). An immediate clinical success was obtained in all patients. During a follow-up of 1–83 months (mean: 29 months), 11 patients were symptom free; 3 patients had recurrent pain; in one patient with inflammatory syndrome, pain relief was obtained with medical treatment; in 2 patients abdominal pain was due to restenosis 36 and 6 months after PTA, respectively. Restenosis was treated by PTA (postirradiation stenosis), and by surgical bypass (atheromatous stenosis). Percutaneous endovascular techniques are safe and accurate. They are an alternative to surgery in patients with chronic mesenteric ischemia due to short and proximal occlusive lesions of SMA and CA.
- 4.Yamakado, K, Takeda, K, Nomura, Y, et al. 1998Relief of mesenteric ischemia by Z-stent placement into the superior mesenteric artery compressed by the false lumen of an aortic dissectionCardiovasc Intervent Radiol216668Google Scholar
- 6.Deklunder G, Dauzat M (1995). Semiologie des stenoses arterielles. In: Plainfosse MC, Masson (ed) Echographie doppler en pratique viscerale et peripherique, Paris, pp 31–35Google Scholar
- 10.Cluzel P, Auguste M, Galvez V (1999) Traitement endovasculaire des artères digestives. Kieffer E, Parc E Aercv (eds) Chirurgie des arteres digestives, pp 145–153. ParisGoogle Scholar
- 11.Liermann, D, Strecker, EP 1995Tantalum stents in the treatment of stenotic and occlusive disease of abdominal vesselsLiebermann, DD eds. Polyscience stents: state of the art and future developments.Watertown127134Google Scholar
- 16.Pietura, R, Szymanska, A, El Furah, M, et al. 2002Chronic mesenteric ischemia: diagnosis and treatment with balloon angioplasty and stenting:Med Sci Monit8812Google Scholar