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Irish Journal of Medical Science

, Volume 183, Issue 2, pp 181–185 | Cite as

Mid-term follow-up of stenting in chronic mesenteric ischaemia: a review of six cases

  • M. Sharkawi
  • H. E. Alfadhel
  • M. D. Burns
  • M. Given
  • M. J. LeeEmail author
Original Article

Abstract

Background

Chronic mesenteric angina is a rare condition with high morbidity and mortality, which occurs due to stenosis or occlusion in the mesenteric vessels commonly due to atherosclerosis. Typically, patients present with worsening postprandial abdominal pain, chronic weight loss and fear of food. The condition can be treated by surgical bypass, but also by percutaneous transluminal angioplasty and stenting of the affected mesenteric arteries.

Aim

To assess the mid-term outcomes in patients treated by endovascular stenting for chronic mesenteric ischaemia (CMI).

Methods

Six patients were treated for symptomatic CMI. In total, six severely stenosed vessels were stented including the superior mesenteric artery (n = 5) and coeliac artery (n = 1). A retrospective review of these patients was performed with end points including symptom recurrence, major morbidity and mortality. The mean follow-up was 16.5 months (range 5–28 months).

Results

Initial clinical success was observed in all six patients. Four patients were clinically asymptomatic, but died within 18 months after the procedure from other conditions. One patient suffered from recurrence of symptoms. Only one patient died as a consequence of mesenteric artery re-stenosis.

Conclusion

Stenting of mesenteric vessels has shown excellent early and mid-term clinical success in selected patients. Though no direct comparison with open revascularization surgery was performed in this case series, technical and mid-term clinical success is promising.

Keywords

Mesenteric ischaemia Chronic Endovascular Stenting Mid-term Follow-up 

References

  1. 1.
    Nyman U, Ivancev K, Lindh M et al (1998) Endovascular treatment of chronic mesenteric ischemia: report of five cases. CVIR 21:305–313PubMedCrossRefGoogle Scholar
  2. 2.
    Paterno F, Longo WE (2008) The etiology and pathogenesis of vascular disorders of the intestine. Radiol Clin North Am 46(5):877–885PubMedCrossRefGoogle Scholar
  3. 3.
    Fioole B, Van De Rest HJ, Meijer JR et al (2010) Percutaneous transluminal angioplasty and stenting as first-choice treatment in patients with chronic mesenteric ischemia. J Vasc Surg 51(2):386–391PubMedCrossRefGoogle Scholar
  4. 4.
    Taylor LM, Porter JM (1995) Treatment of chronic visceral ischemia. In: Rutherford RB (ed) Vascular surgery, vol 4. WB Saunders, Philadelphia, pp 1301–1311Google Scholar
  5. 5.
    Tyson R (2010) Diagnosis and treatment of abdominal angina. Nurse Pract 35(11):16–22PubMedCrossRefGoogle Scholar
  6. 6.
    Gibbons CP, Roberts DE (2010) Endovascular treatment of chronic arterial mesenteric ischemia: a changing perspective? Semin Vasc Surg 23(1):47–53PubMedCrossRefGoogle Scholar
  7. 7.
    Taylor LM, Moneta GM (1991) Intestinal ischemia. Ann Vasc Surg 5:403–406PubMedCrossRefGoogle Scholar
  8. 8.
    Peck MA, Conrad MF, Kwolek CJ et al (2010) Intermediate-term outcomes of endovascular treatment for symptomatic chronic mesenteric ischemia. J Vasc Surg 51(1):140–147PubMedCrossRefGoogle Scholar
  9. 9.
    Kougias P, Huynh TT, Lin PH (2009) Clinical outcomes of mesenteric artery stenting versus surgical revascularisation in chronic mesenteric ischemia. Int Angiol 28:132–137PubMedGoogle Scholar
  10. 10.
    Schermerhorn ML, Giles KA, Hamdan AD et al (2009) Mesenteric revascularization: management outcomes in the United States, 1988–2006. J Vasc Surg 50:341–348PubMedCentralPubMedCrossRefGoogle Scholar
  11. 11.
    Matsumoto AH, Angle JF, Spinosa DJ et al (2002) Percutaneous trans-luminal angioplasty in the treatment of chronic mesenteric ischemia: results and longterm follow up. J Am Coll Surg 194:S22–S31PubMedCrossRefGoogle Scholar

Copyright information

© Royal Academy of Medicine in Ireland 2013

Authors and Affiliations

  • M. Sharkawi
    • 1
  • H. E. Alfadhel
    • 1
  • M. D. Burns
    • 2
  • M. Given
    • 3
  • M. J. Lee
    • 3
    • 4
    Email author
  1. 1.Radiology DepartmentBahrain Defence Force HospitalRiffaBahrain
  2. 2.Vancouver General HospitalUniversity of British ColumbiaVancouverCanada
  3. 3.Radiology DepartmentBeaumont HospitalDublin 9Ireland
  4. 4.Radiology Department, Royal College of Surgeons in IrelandDublin 2Ireland

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