Endovascular management of chronic mesenteric ischemia: a single centre experience in Western Rajasthan, India

Authors

  • Pawan Sarda Department of Cardiology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India
  • Goutam Kumar Department of Cardiology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India
  • Deepak Gupta Department of Cardiology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India
  • Sanjeev Sanghvi Department of Cardiology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India
  • Anil Baroopal Department of Cardiology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India http://orcid.org/0000-0003-4227-1100

DOI:

https://doi.org/10.18203/2320-6012.ijrms20172449

Keywords:

Chronic mesenteric ischaemia, Percutaneous transluminal angioplasty

Abstract

Background: Chronic mesenteric ischemia (CMI) or mesenteric angina is a condition characterised by inadequate blood supply to bowel as a result of stenosis affecting   one or more of the three mesenteric arteries: the celiac artery (CA), the superior mesenteric artery (SMA) and the inferior mesenteric artery (IMA).

Methods: Ten patients with significant lesion, treated with PTA and stenting were selected for study and were followed at 2 weeks, at 2 months then at 6 months after index procedure to see composite of symptomatic improvement, weight gain and revascularization.

Results: On mesenteric angiography, significant ostial stenosis of celiac trunk and superior mesenteric artery in 5 patients, 3 patients had significant ostial stenosis of celiac trunk and ostial stenosis of inferior mesenteric artery and 2 patients had significant stenosis of superior mesenteric artery. Percutaneous transluminal angioplasty (PTA) and stenting was done, final result was good and there was no residual stenosis and dissection. After stenting patients were stable and pain free. There were no post-operative complications. Follow up was done after 2 weeks and 2 months and then at six months. There was no postprandial abdominal pain on follow up and almost all patient had gained weight in 2 months and on 6 months of follow up, no case of repeat revascularization was recorded.

Conclusions: Percutaneous transluminal angioplasty (PTA) and stenting to mesenteric artery is good alternative management of CMI. In present series, all cases were susses fully revascularized without residual stenosis and dissection.

Author Biographies

Pawan Sarda, Department of Cardiology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India

department of cardiology dr sn medical college jodhpur

Goutam Kumar, Department of Cardiology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India

department of cardiology dr sn medical college

Deepak Gupta, Department of Cardiology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India

department of cardiology dr sn medical college

Sanjeev Sanghvi, Department of Cardiology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India

department of cardiology dr sn medical college

Anil Baroopal, Department of Cardiology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India

department of cardiology dr sn medical college

References

AbuRahma AF, Stone PA, Bates MC, Welch CA. Angioplasty/stenting of the superior mesenteric artery and celiac trunk: early and late outcomes. J Endovasc Ther. 2003;10(6):1046-53.

Chang RW, Chang JB, Longo WE. Update in management of mesenteric ischemia. World J Gastroenterol. 2006;12(20):3243-7.

Matsumoto AH, Tegtmeyer CJ, Fitzcharles EK, Selby JB Jr, Tribble CG, Angle JF, et al. Percutaneous transluminal angioplasty of visceral arterial stenoses: results and long-term clinical follow-up. J Vasc Interv Radiol. 1995;6(2):165-74.

Loffroy R, Steinmetz E, Guiu B, Molin V, Kretz B, Gagnaire A, et al. Role of endovascular therapy in chronic mesenteric ischemia. Can J Gastroenterol 2009;23(5):365-73.

Kasirajan K1, O'Hara PJ, Gray BH, Hertzer NR, Clair DG, Greenberg RK, et al. Chronic mesenteric ischemia: open surgery versus percutaneous angioplasty and stenting. J Vasc Surg. 2001;33(1):63-71.

Rose SC, Quigley TM, Raker EJ. Revascularisation for chronic mesenteric ischemia: comparison of operative arterial bypass grafting and percutaneous transluminal angioplasty. J Vasc Interv Radiol. 1995;6(3):339-49.

Mateo RB, O'Hara PJ, Hertzer NR, Mascha EJ, Beven EG, Krajewski LP. Elective surgical treatment of symptomatic chronic mesenteric occlusive disease: early results and late outcomes. J Vasc Surg. 1999;29(5):821-31.

Uflacker R, Goldany MA, Constant S. Resolution of mesenteric angina with percutaneous transluminal angioplasty of a superior mesenteric artery stenosis using a balloon catheter. Gastrointest Radiol 1980;5(4):367-9.

Furrer J, Gruntzig A, Kugelmeier J, Goebel N. Treatment of abdominal angina with percutaneous dilatation of an arteria mesenterica superior stenosis. Cardiovasc Intervent Radiol. 1980;3(1):43-4.

Sharafuddin MJ, Olson CH, Sun S, Kresowik TF, Corson JD. Endovascular treatment of celiac and mesenteric arteries stenoses: applications and results. J Vasc Surg 2003;38(4):692-8.

Kougias P, El Sayed HF, Zhou W, Lin PH. Management of chronic mesenteric ischemia: The role of endovascular therapy. J Endovasc Ther 2007;14(3):395-405.

Oderich GS, Bower TC, Sullivan TM, Bjarnason H, Cha S, Gloviczki P. Open versus endovascular revascularisation for chronic mesenteris ischemia: Risk stratified outcome. Society for Vascular Surgery Annual Meeting. Philadelphia. 2006. 2009;49(6):1472-9.

Pecoraro F, Rancic Z, Lachat M, Mayer D, Amann-Vesti B, Pfammatter T et al. Chronic mesenteric ischemia: critical review and guidelines for management. Ann Vasc Surg. 2013;27(1):113-22.

Tallarita T, Oderich GS, Gloviczki P. Patient survival after open and endovascular mesenteric revascularization for chronic mesenteric ischemia. J Vasc Surg. 2013;57(3):747-55.

Grilli CJ, Fedele CR, Tahir OM. Recanalization of chronic total occlusions of the superior mesenteric artery in patients with chronic mesenteric ischemia: technical and clinical outcomes. J Vasc Interv Radiol. 2014;25(10):1515-22.

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Published

2017-05-27

How to Cite

Sarda, P., Kumar, G., Gupta, D., Sanghvi, S., & Baroopal, A. (2017). Endovascular management of chronic mesenteric ischemia: a single centre experience in Western Rajasthan, India. International Journal of Research in Medical Sciences, 5(6), 2572–2574. https://doi.org/10.18203/2320-6012.ijrms20172449

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Original Research Articles