title: Stenting of stenotic mesenteric arteries for symptomatic chronic mesenteric ischemia.
abstract: BACKGROUND
  We report the results of our single center series of patients with chronic mesenteric ischemia (CMI) to determine the role of stenting in the management of patients.
  
  
  METHODS
  We retrospectively reviewed all patients with CMI treated endovascularly with stent revascularisation from January 2008 to January 2011.CMI diagnosis was made according to clinical symptoms, including postprandial abdominal pain, food fear, and weight loss. Additionally, the diagnosis was confirmed by duplex ultrasonography and/or computed tomography angiography and/or contrast-enhanced magnetic resonance angiography.
  
  
  RESULTS
  All 45 patients presented with typical CMI symptoms: 45/45 (100 %) had postprandial pain, 31/45 (68.8 %) had a weight loss of more than 10 kilograms, and 11/45 (24.4 %) suffered from ischemic colitis combined with lower gastrointestinal bleeding. In three patients occlusion could not be crossed, therefore considered as technical failure. A total of 55 arteries were stented in the remaining 42 patients. Nineteen patients underwent SMA stenting alone, eight underwent celiac stenting, alone and three patients underwent stenting of inferior mesenteric artery (IMA) alone. We performed combined stenting of the celiac artery and superior mesenteric artery in ten patients, and one patient underwent a combined stenting of the celiac artery and the IMA. All three mesenteric arteries were stented in only one patient. Primary technical success was achieved in 42/45 (94.8 %) patients. Clinical symptom relief was achieved in 39/45 (86.6 %) patients with abdominal pain. Increased body weight was observed in 28/31 (90.3 %) patients with an average weight gain of 8.8 kilograms (5 - 12 kilograms), and 10/11 (90.9 %) patients recovered from ischaemic colitis/lower gastrointestinal bleeding.
  
  
  CONCLUSIONS
  Stent revascularisation can be considered as the first-line therapy for patients with chronic mesenteric ischemia.
authors.affiliation: Diagnostic and Interventional Radiology and Neuroradiology, Helios Hospital Erfurt, Germany. rene.aschenbach@helios-kliniken.de
authors.forename: R
authors.initials: R
authors.lastname: Aschenbach
authors.forename: H
authors.initials: H
authors.lastname: Bergert
authors.forename: M
authors.initials: M
authors.lastname: Kerl
authors.forename: S
authors.initials: S
authors.lastname: Zangos
authors.forename: A
authors.initials: A
authors.lastname: Neumeister
authors.forename: A
authors.initials: A
authors.lastname: Schlosser
authors.forename: S
authors.initials: S
authors.lastname: Basche
authors.forename: T
authors.initials: T
authors.lastname: Vogl
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D002445:Celiac Artery; D003251:Constriction, Pathologic; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D005858:Germany; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D053208:Kaplan-Meier Estimate; D018810:Magnetic Resonance Angiography; D008297:Male; D008638:Mesenteric Arteries; D065666:Mesenteric Ischemia; D008641:Mesenteric Vascular Occlusion / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014652:Vascular Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D015431:Weight Loss