title: Use of fractional flow reserve in the assessment of chronic mesenteric ischemia.
abstract: Chronic mesenteric ischemia (CMI) is a rare condition that is usually the result of atherosclerotic obstructive disease affecting the mesenteric arteries. The classic triad of post-prandial pain, food aversion and weight loss is not always present, often leading to low clinical suspicion for CMI and underdiagnosis. Non-invasive evaluation for CMI usually starts with mesenteric arterial duplex scanning, followed by computed tomography angiography, magnetic resonance angiography or conventional angiography, the latter being the gold standard for establishing its diagnosis. However, angiography alone has been demonstrated in coronary and other vascular beds to be inaccurate in predicting the physiologic and hemodynamic significance of a certain subset of atherosclerotic stenoses. We present the case of a patient with risk factors and symptoms suggestive of CMI who underwent angiography. However, angiography was equivocal and invasive physiologic testing was required to confirm the diagnosis and guide revascularization.
authors.affiliation: Division of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, CT, USA Immad.Sadiq@hhchealth.org.
authors.forename: Immad
authors.initials: I
authors.lastname: Sadiq
authors.affiliation: Division of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, CT, USA.
authors.forename: Sanjayant
authors.initials: S
authors.lastname: Chamakura
authors.affiliation: Division of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, CT, USA.
authors.forename: Saadi
authors.initials: S
authors.lastname: Siddiqi
authors.affiliation: Division of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, CT, USA.
authors.forename: Ronan
authors.initials: R
authors.lastname: Margey
authors.affiliation: Division of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, CT, USA.
authors.forename: Talhat
authors.initials: T
authors.lastname: Azemi
keywords: celiac artery; hemodynamic processes; mesenteric artery