Endovascular treatment of arterial mesenteric ischaemia: A retrospective review

Abstract

Mesenteric ischaemia is a condition that has traditionally been managed surgically. It poses a challenging diagnostic and therapeutic problem, particularly in the acute setting. We review a small series of eight patients managed with endovascular techniques for either acute or chronic mesenteric ischaemia at The Royal Melbourne Hospital, from 1997 to 2002. We describe our results and relate these to the recent published literature regarding endovascular and surgical management of mesenteric ischaemia. Our experience confirms the valuable contribution of angioplasty and stenting in chronic mesenteric ischaemia, which compares favourably with surgery with regards to complication rates and mortality. We suggest the need for further studies to compare the long-term efficacy of endovascular techniques compared with surgery in the management of chronic mesenteric ischaemia. Furthermore, we demonstrate a role for endovascular management in acute mesenteric ischaemia, in the appropriate clinical setting.

Acute Mesenteric Ischemia: Multidetector CT Findings and Endovascular Management

“…Angioplasty and stent placement are performed when underlying vascular stenosis has manifested, and therefore the procedures are more frequently performed in cases of MAT (42,43). Possible complications from these procedures include vascular injuries, such as dissection and occlusion, and stent dislocation (44).…”

Endovascular versus open revascularization for chronic mesenteric ischemia: a comparative study

“…According to the literature, PTA probably sustained a greater risk of restenosis with concomitant recurrent symptoms and possible 8 80 13 25 9 57 33 69.9 Kasirajan, 2001 28 100 11 18 27 73 34 72 Sivamurthy, 2006 22 95 16 19 NA 68 80 72 Atkins, 2007 31 97 3 13 15 58 26 69 Biebl, 2007 23 NA 0 4 10 75 25 70.8 Present, 2007 14 93 14 21 15 58 29 75.4 NA Not available AII. This high re-stenosis rate emphasizes the need for appropriate follow-up by imaging [13,17]. Following a patient only clinically exposed to inadequate evaluation of vessel re-stenosis, we advocate the use of CT scan angiography or magnetic resonance angiography in PTA or BPG follow-up.…”

Atherosclerotic disease of the abdominal aorta and its branches: prognostic implications in patients with heart failure

“…However, patients with flash pulmonary oedema were excluded, and many patients had only moderate renal artery stenosis (\70%) which may not have been severe enough to benefit from the procedure. Angioplasty is also used to manage mesenteric stenosis, but evidence that the benefits outweigh the risks is lacking [29].…”