title: Endovascular treatment of chronic mesenteric ischemia: results in 14 patients.
abstract: We evaluated immediate and long-term results of percutaneous transluminal angioplasty (PTA) and stent placement to treat stenotic and occluded arteries in patients with chronic mesenteric ischemia. Fourteen patients were treated by 3 exclusive celiac artery (CA) PTAs (2 stentings), 3 cases with both Superior Mesenteric Artery (SMA) and CA angioplasties, and 8 exclusive SMA angioplasties (3 stentings). Eleven patients had atheromatous stenoses with one case of an early onset atheroma in an HIV patient with antiphospholipid syndrome. The other etiologies of mesenteric arterial lesions were Takayashu arteritis (2 cases) and a postradiation stenoses (1 case). Technical success was achieved in all cases. Two major complications were observed: one hematoma and one false aneurysm occurring at the brachial puncture site (14.3%). An immediate clinical success was obtained in all patients. During a follow-up of 1-83 months (mean: 29 months), 11 patients were symptom free; 3 patients had recurrent pain; in one patient with inflammatory syndrome, pain relief was obtained with medical treatment; in 2 patients abdominal pain was due to restenosis 36 and 6 months after PTA, respectively. Restenosis was treated by PTA (postirradiation stenosis), and by surgical bypass (atheromatous stenosis). Percutaneous endovascular techniques are safe and accurate. They are an alternative to surgery in patients with chronic mesenteric ischemia due to short and proximal occlusive lesions of SMA and CA.
authors.affiliation: Radiology Department, University Hospital, Clermont-Ferrand, France.
authors.forename: Tamam
authors.initials: T
authors.lastname: Chahid
authors.forename: Agaicha T
authors.initials: AT
authors.lastname: Alfidja
authors.forename: Marie
authors.initials: M
authors.lastname: Biard
authors.forename: Anne
authors.initials: A
authors.lastname: Ravel
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: Garcier
authors.forename: L
authors.initials: L
authors.lastname: Boyer
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon / Q000379:methods*; D000890:Anti-Infective Agents / Q000008:administration & dosage; D000925:Anticoagulants / Q000008:administration & dosage; D002445:Celiac Artery / Q000000981:diagnostic imaging; D002908:Chronic Disease; D003251:Constriction, Pathologic / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007511:Ischemia / Q000628:therapy*; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging; D008641:Mesenteric Vascular Occlusion / Q000628:therapy*; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D020156:Salicylic Acid / Q000008:administration & dosage; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D000890:Anti-Infective Agents; D000925:Anticoagulants; D006493:Heparin; D020156:Salicylic Acid