Transluminal angioplasty of the superior mesenteric artery: an alternative to surgical revascularization

Abstract

These patients are occasionally poor surgical candidates and are at risk for increased morbidity after extensive surgical procedures. Our results and those of others [2][3][4][5][6] indicate that transluminal angioplasty of the superior mesenteric artery for intestinal ischemia is potentially a safe alternative to surgical intestinal revascularization. We report our experience with percutaneous transluminal angioplasty of the superior mesenteric artery in four patients. Subjects and Methods Received

Percutaneous transluminal angioplasty in the treatment of chronic mesenteric ischemia: results and 3 years of follow-up in 23 patients

“…The long-term clinical success of our study (88% Å mean follow-up at 27 months) is similar to that of other investigators (63-100%, mean Å 77% for follow-up periods of 3-60 months) [3][4][5][6][7][8][9][10][11][12]. The primary longterm clinical success is equal to that of surgery (50-100%, mean Å 84% for follow-up periods of 24-69 months) [2,[15][16][17][18][19][20][21][22][23][24][25].…”

“…Our results on PTA of visceral arteries coincide with those of other investigators (Table 3) where the technical success rate in relation to the number of patients is 81% (range Å 25-100%), the technical success rate in relation to the number of lesions is 72% (range Å 30-89%), the initial clinical success rate is 96% (range Å 80-100%), the periprocedural mortality rate is 2% (range Å 0-13%), and the morbidity rate is 10% (range Å 0-25%) [2][3][4][5][6][7][8][9][10][11]. Such results compared with those carried out by surgery are encouraging.…”

ACC/AHA 2005 Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic): A Collaborative Report from the American Association for Vascular Surgery/Society for Vascular Surgery,⁎Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients

“…Since then, a large number of reports in the literature have documented that percutaneous interventional treatment of intestinal arterial obstructions is possible with a high technical success rate and few complications in properly selected cases (844)(845)(846)(847)(848)(849). Most procedures have been performed to treat intestinal arterial stenoses, with few attempting to treat occlusions.…”

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

“…Percutaneous transluminal angioplasty and stenting has been previously described for the management of chronic mesenteric ischaemia with good short‐term results 9,10 . It does not have an established role in the acute setting, as the likelihood of bowel necrosis at the time of diagnosis is high.…”