Chronic mesenteric ischaemia: 28-year experience of endovascular treatment

Turba, Ulku C.; Saad, Wael E.A.; Arslan, Bülent; Sabri, Saher S.; Trotter, Stacey A.; Angle, John F.; Hagspiel, Klaus D.; Kern, John A.; Cherry, Kenneth J.; Matsumoto, Alan H.

doi:10.1007/s00330-011-2376-z

Cited by 36 publications

(18 citation statements)

References 25 publications

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“…Moreover, volumetric reconstruction of data makes CT a useful tool during pre-procedural planning of a percutaneous approach. The treatment of the mesenteric vessels involves the aorta or mesenteric vessel origin more than 95% of the time [6][7][8]. The infrarenal abdominal aorta develops atherosclerotic changes earlier than the supra-renal aorta.…”

Section: Discussionmentioning

confidence: 99%

Middle Aortic Syndrome with Mesenteric artery stenosis- successful percutaneous endovascular reconstruction

et al. 2016

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Chronic mesenteric ischemia (CMI) is a challenging problem especially when both the superior mesenteric artery (SMA) and celiac artery (CA) are involved. We report a case 65year-old female with hypertension, type II diabetes, and dyslipidemia who presented with exertional angina for 11-months duration and abdominal angina with weight loss for 5months. Coronary computed tomographic (CT) angiogram revealed critical discrete lesion of mid right coronary artery (RCA). A contrast CT angiogram revealed a high grade, long segment stenosis of supra-renal abdominal aorta which was mildly calcified, mild ostial stenosis of celiac artery, and critical ostial stenosis of superior mesenteric artery (SMA) suggesting middle aortic syndrome with mesenteric artery stenosis. RCA was revascularised by deployment of 3.5 x 18 mm Xience prime Everolimus eluting stent (Abott Vascular; USA) at 13 atm pressure achieving TIMI III flow through left transbrachial approach. Aorta was stented transfemorally using two overlapping Epic self-expanding stents (Boston scientific, USA)-12x60 mm proximally and 10 x 40 mm distally. SMA was stented with 6 x 18 mm stent (Herculink, Boston, USA) after predilatation achieving complete revascularization.

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Section: Discussionmentioning

confidence: 99%

Middle Aortic Syndrome with Mesenteric artery stenosis- successful percutaneous endovascular reconstruction

et al. 2016

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“…Good clinical outcomes have been reported with 1-year primary and secondary patency rates of 40%-70% and 85%-95%, respectively. [1][2][3][4] Bare-metal and covered stents have both been used, with early data suggesting a possible advantage to the covered variety. 5 Although cardiopulmonary complications and overall morbidity are higher with open surgery, mortality rates are comparable at 5%-10%, 6 and mesenteric artery complications with percutaneous approaches drastically increase the risk of subsequent death.…”

Section: Discussionmentioning

confidence: 99%

Endovascular recanalization of the superior mesenteric artery in the context of mesenteric bypass graft infection

Johnston

Guercio

Johnson

et al. 2013

Journal of Vascular Surgery

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Mesenteric prosthetic graft infection is a rare and challenging clinical scenario. A patient is described who developed recurrent abdominal pain after occlusion of an iliomesenteric prosthetic bypass. Endovascular recanalization of the native superior mesenteric artery, which had been occluded for more than 10 years, was accomplished using axillofemoral through-wire access and a steerable guiding catheter. The infected prosthetic was then explanted and his graft-enteric fistula repaired. Technical and strategic considerations are discussed.

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“…Turba et al reported a retrospective series of 166 consecutive patients undergoing ET for CMI [31]. The technical success rate was 97% per patient and was higher for stenting than PTA (99.4 vs 86%; p = 0.0001).…”

Section: Outcomementioning

confidence: 93%

“…Disadvantages of the brachial approach include the need for longer catheters and devices due to increased distance from the target vessels, limited maximal sheath size of 7 Fr without surgical exposure of the brachial artery and the risk of embolic stroke from wire manipulation in the aortic arch. One recent study has shown that the type of guidewire or device platform, brachial versus femoral access, and the presentation (stenosis vs total occlusion) had no impact on mortality or primary patency [31].…”

Section: Management and Techniquementioning

confidence: 99%

Technique profile: mesenteric reconstructions for occlusive disease

Shah¹,

Schwartz

Moawad

et al. 2015

Expert Review of Cardiovascular Therapy

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Visceral ischemic syndromes are rare but catastrophic disorders. In acute presentations, treatment modalities include thrombolytic therapy, open surgical revascularization and percutaneous endovascular therapy. Endovascular therapy has become the most commonly utilized treatment option for chronic mesenteric ischemia and should be considered the first line of therapy for patients with anatomically suitable lesions or excessive open surgical risk. Open surgical revascularization has been associated with outstanding long-term outcomes. The various surgical and endovascular techniques and their associated outcomes for the treatment of mesenteric ischemic syndromes are reviewed in detail.

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Chronic mesenteric ischaemia: 28-year experience of endovascular treatment

Cited by 36 publications

References 25 publications

Middle Aortic Syndrome with Mesenteric artery stenosis- successful percutaneous endovascular reconstruction

Middle Aortic Syndrome with Mesenteric artery stenosis- successful percutaneous endovascular reconstruction

Endovascular recanalization of the superior mesenteric artery in the context of mesenteric bypass graft infection

Technique profile: mesenteric reconstructions for occlusive disease

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