European Radiology

, Volume 22, Issue 6, pp 1372–1384 | Cite as

Chronic mesenteric ischaemia: 28-year experience of endovascular treatment

  • Ulku Cenk Turba
  • Wael E. Saad
  • Bulent Arslan
  • Saher S. Sabri
  • Stacey Trotter
  • John F. Angle
  • Klaus D. Hagspiel
  • John A. Kern
  • Kenneth J. Cherry
  • Alan H. Matsumoto
Vascular-Interventional

Abstract

Objective

To report the outcomes associated with endovascular therapy for patients with chronic mesenteric ischemia (CMI).

Methods

A retrospective review of patients who underwent endovascular therapy for CMI between April 1981 and September 2009 at a single institution was performed. Procedural details, mesenteric arteries treated, technical and clinical success rates, outcomes per patient and per vessel were assessed.

Results

In 166 patients treatment was attempted using a variety of balloon and stent platforms during the 28-year period. The technical success rate was 97% per patient and 94% per vessel. The technical success rate of stenting (99.4%) was higher than for percutaneous transluminal angioplasty (PTA; 86%; P = 0.0001). Immediate clinical improvement was seen in 146 out of 166 (88.2%). The type of guidewire or device platform, brachial vs. femoral artery access, balloon and/or stent diameters used, and stenosis vs. occlusion had no statistical impact on mortality or the primary patency of any mesenteric artery outcomes. The outcome of the superior mesenteric artery (SMA) with PTA appears to be superior to that of stenting (P = 0.014).

Conclusion

Technical success rates are improved with the use of stents; however, PTA use in the SMA seems to offer better primary patency rates.

Key Points

Superior mesenteric artery (SMA) stenosis is often responsible for ischaemic symptoms.

Treatment with percutaneous transluminal angioplasty (PTA) seems superior to stenting

Although technical success rates are improved with the use of stents.

Higher mortality in the elderly and those presenting with nausea/vomiting/bloody stools.

Keywords

Mesenteric artery/blood supply Ischemia/etiology/therapy Angioplasty Balloon Stents Treatment outcome 

Notes

Acknowledgement

Special thanks to Dorothy L. Cage RN, BSN for reviewing some of the patients’ data in this article.

Disclosure statement

Alan H. Matsumoto; Grant support: NIH, W.L. Gore, Medtronic, Cook, Insightec, Endologix. DSMB activities: Trivascular, Bolton Medical. Advisory Board/Consultant, Siemens Medical, St Judes Medical, Boston Scientific, Crux Medical, Bard Peripheral Vascular. Other authors; None.

Conflict of interest

We had no financial support or conflict of interest for this project.

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Copyright information

© European Society of Radiology 2012

Authors and Affiliations

  • Ulku Cenk Turba
    • 1
    • 4
  • Wael E. Saad
    • 1
  • Bulent Arslan
    • 2
  • Saher S. Sabri
    • 1
  • Stacey Trotter
    • 3
  • John F. Angle
    • 1
  • Klaus D. Hagspiel
    • 1
  • John A. Kern
    • 1
  • Kenneth J. Cherry
    • 1
  • Alan H. Matsumoto
    • 1
  1. 1.Interventional RadiologyUniversity of VirginiaCharlottesvilleUSA
  2. 2.Interventional RadiologyH. Lee Moffitt Cancer Center & Research InstituteTampaUSA
  3. 3.Johns Hopkins, RadiologyBaltimoreUSA
  4. 4.University of Virginia Health SystemCharlottesvilleUSA

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