Endovascular Therapy for Chronic Mesenteric Ischemia
Jose A. Silva, MD, FACC*,*,
Christopher J. White, MD, FACC*,
Tyrone J. Collins, MD, FACC*,
J. Stephen Jenkins, MD, FACC*,
Malcolm E. Andry, MD ,
John P. Reilly, MD, FACC* and
Stephen R. Ramee, MD, FACC*
* Cardiology
Medicine, Section of Gastroenterology, Ochsner Clinic Foundation, New Orleans, Louisiana
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Figure 1 A 72-year-old male patient with typical symptoms of chronic mesenteric ischemia.
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Figure 2 A 61-year-old woman with symptoms of ischemic gastropathy for more than one year and occlusion of all three mesenteric arteries. The superior mesenteric artery was successfully recanalized and stented, with immediate resolution of her symptoms.
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Figure 3 A 67-year-old man with ischemic cardiomyopathy who developed abdominal pain and lower gastrointestinal bleeding. Mesenteric angiography showed high grade stenosis of the celiac trunk and inferior mesenteric arteries, which were successfully stented with resolution of symptoms. A two-year follow-up angiogram revealed patent mesenteric stents (last upper and lower panels on the right).
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Figure 4 A 38-year-old woman with extrinsic compression of the celiac trunk and history of crampy abdominal pain and bloody diarrhea. The patient refused surgical decompression and underwent successful stent placement with resolution of symptoms. The six-month angiographic computed tomography scan (last panel on the right) revealed >50% in-stent restenosis but patency of the stent and no inspiratory collapse. She has had no recurrence of symptoms at follow-up more than three years later.
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Figure 5 Kaplan-Meier survival curves showing the five-year cumulative probability of survival, symptom-free, and symptom-free survival of the 59 patients.
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