Endovascular treatment of chronic splanchnic syndrome.
OBJECTIVE
The technical and clinical outcome of endovascular revascularization was analyzed in patients with suspicion of chronic splanchnic syndrome (CSS).


METHODS
Medical history, duplex, angiography and exercise gastric tonometry suggested CSS in 97 patients. Twenty-seven of them were treated endovascular (one patient had 3-vessel, 12 patients had 2-vessels, 14 patients had 1-vessel CSS). Five patients received previous splanchnic revascularization. Twenty-three patients (85%) had severe co-morbidity: cardiac, pulmonary or cachexia. Endovascular treatment consisted of percutaneous transluminal angiography (PTA) of the coeliac artery (CA) or superior mesenteric artery (SMA) in three and primary balloon expandable stenting in 24 patients (13 CA and 10 SMA solitary, two CA and SMA both, 31 splanchnic arteries in total).


RESULTS
Three patients showed procedure related complications (11%). Mean follow-up was 19, range 2-76 months. Two patients died during follow up, both not procedure or CSS related. Five patients had no improvement of symptoms, without evidence of re- or residual stenosis. The primary clinical success was 67%, secondary clinical success was 81%. The primary patency was 81% and secondary patency was 100%.


CONCLUSIONS
Endovascular treatment of CSS has a reasonable outcome. It is an alternative to operative treatment, especially in patients with high co-morbidity or limited life expectancy.
van Wanroij
J L
JL
Department of Vascular Surgery, Medisch Spectrum Twente Hospital, Enschede, The Netherlands.
van Petersen
A S
AS
Huisman
A B
AB
Mensink
P B F
PB
Gerrits
D G
DG
Kolkman
J J
JJ
Geelkerken
R H
RH
D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D002445:Celiac Artery; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior; D012189:Retrospective Studies; D013152:Splanchnic Circulation; D015607:Stents; D013577:Syndrome