Mesenteric artery disease in the elderly

Hansen, Kimberley J.; Wilson, David B.; Craven, Timothy E.; Pearce, Jeffrey D.; English, William P.; Edwards, Matthew S.; Ayerdi, Juan; Burke, Gregory L.

doi:10.1016/j.jvs.2004.03.022

Cited by 170 publications

(83 citation statements)

References 17 publications

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“…In a retrospective study including 980 patients with a mean age of 68 years who underwent angiography for various indications, 8% had significant stenoses of at least one splanchnic artery [9] . In a screening study with duplex ultrasonography in 553 healthy elderly subjects with a mean age of 84 years, stenoses in the celiac artery (CA) or superior mesenteric artery (SMA) were found in 18% [10] . In patients with atherosclerotic disorders of aorta, iliac and femoral vessels the incidence ranged from 25% to 40% [11,12] .…”

Section: Epidemiologymentioning

confidence: 99%

Diagnosis and management of splanchnic ischemia

Kolkman¹,

Bargeman²,

Huisman³

et al. 2008

WJG

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Section: Epidemiologymentioning

confidence: 99%

Diagnosis and management of splanchnic ischemia

Kolkman¹,

Bargeman²,

Huisman³

et al. 2008

WJG

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“…However, Hansen et al reported that 12.8% of patients with SMA stenosis had concomitant renal artery stenosis. 8) The American College of Cardiology/American Heart Association 2005 practice guidelines recommended that revascularization of asymptomatic intestinal arterial obstructions may be considered for patients undergoing aortic/renal artery surgery for other indications (Class IIb). 9) Because one-staged revascularization surgery of both renal artery and SMA is less invasive and more beneficial than two-staged surgery in a low-risk patient, we performed SMA bypass surgery simultaneously with AAA repair.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Abdominal Aortic Aneurysm with Congenital Solitary Pelvic Kidney and Superior Mesenteric Artery Stenosis

Saito

Tanaka

Yamamoto

et al. 2016

Annals of Vascular Diseases

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We report the rare case of a 54-year-old man with uncontrolled renovascular hypertension, who was found to have an abdominal aortic aneurysm with congenital solitary pelvic kidney and superior mesenteric artery stenosis. A single renal artery branched from aneurysmal aortic bifurcation, and both the renal artery and the superior mesenteric artery (SMA) had severe stenosis at their origins. The aneurysm was repaired with a bifurcated Dacron graft, to which the renal artery was anastomosed. SMA bypass was created between the graft's left limb and the SMA using another Dacron graft. The operation was successful, with improvement in renal functions and control of hypertension. Keywords: abdominal aortic aneurysm, congenital solitary pelvic kidney, renovascular hypertension Case ReportA 54-year-old man was referred to our hospital with the diagnosis of AAA, and he presented with renovascular hypertension, renal anemia, and impaired renal function. He was 170 cm tall and weighed 54 kg. His hypertension was uncontrolled despite receiving daily doxazosin (alpha blocker) 4 mg, and nifedipine 80 mg. He has been a tobacco smoker for more than 40 years (20 cigarettes a day). He had no surgical history. Preoperative multidetector computed tomography (MDCT) scan showed a fusiform AAA with a maximum diameter of 45 mm, and a functioning congenital solitary pelvic kidney (Fig. 1A). A single renal artery branched from the aneurysmal aortic bifurcation, which showed 90% stenosis at its origin (Fig. 1B). The renal vein drained directly into the inferior vena cava. With regard to preoperative kidney function, serum creatinine level was 2.65 mg/dl, creatinine clearance rate was 30 ml/min, technetium-99m-mercaptoacetylglycylglycylglycine ( 99m Tc-MAG) clearance rate was 52.8 ml/min, hemoglobin level was 11.5 g/dl, and serum renin level was 6.6 ng/ml/hr. Additionally, the superior mesenteric artery (SMA) showed 70% stenosis at its origin, but without abdominal symptoms (Fig. 1A).Open repair of AAA was performed. In the abdominal cavity, there were no anomalies other than the solitary pelvic kidney. During aortic clamping, renal flow was maintained with a temporary bypass between the right brachial and renal arteries by using Brewster's method ( Fig. 2A). 2)

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“…Other causes of CMI include aortic dissection, fibromuscular dysplasia, vasculitides and median arcuate ligament syndrome. Atherosclerotic disease of the mesenteric arteries is estimated to occur in 17% of patients over the age 65 years (Hansen et al, 2004). Despite its prevalence, the majority of these patients are asymptomatic as a result of the extensive collateral circulation between the celiac trunk, superior mesenteric artery (SMA) and inferior mesenteric artery (IMA).…”

Section: Chronic Mesenteric Ischaemiamentioning

confidence: 99%