Angioplasty and stenting of the superior mesenteric artery in acute mesenteric ischaemia

Abstract

Acute mesenteric ischaemia is a challenging diagnostic problem with a very high mortality. Traditionally, laparotomy is required for definitive management. We describe a successful case of angioplasty and stenting of the superior mesenteric artery in a surgically unfit patient. We recommend that stenting be considered only in situations where the diagnosis has been made prior to bowel infarction, and if the patient poses a poor operative risk.

Management of Chronic Mesenteric Ischemia. The Role of Endovascular Therapy

“…Demirpolat et al 33 reported 3 patients with increasing abdominal pain but without peritoneal find-ings who were treated percutaneously with good outcome. Lastly, Lim and colleagues 21,34 have reported the use of an endovascular approach in surgically unfit patients with good result. All these authors emphasized the importance of performing endovascular treatment in the absence of peritoneal signs and only when bowel viability can be assessed either clinically or with imaging techniques.…”

Management of Acute and Chronic Mesenteric Ischemia

“…Endovascular therapy for mesenteric ischemia has been predominantly used for the chronic form of the disease (see below). Sporadic case reports have described successful management of acute embolic mesenteric ischemia with percutaneous angioplasty and stenting (53,54) . There have also been isolated reports of lytic therapy being used for patients with acute mesenteric ischemia secondary to an embolus (55 -59) .…”

Acute mesenteric ischemia

“…Therefore, data about its effective treatment still lack. Chronic mesenteric ischemia treated with percutaneous techniques has already been described [2], but only sparse case reports investigate the safety and the outcome of primary intervention [3].…”