Occlusion of the celiac trunk, the inferior mesenteric artery and stenosis of the superior mesenteric artery in peripheral thrombangiitis obliterans

VASA ◽  
2009 ◽  
Vol 38 (4) ◽  
pp. 394-396 ◽  
Author(s):  
Çakmak ◽  
Gyedu ◽  
Akyol ◽  
İ. Kepenekçi ◽  
Köksoy
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Celiac Trunk ◽  
Occlusive Disease ◽  
Mesenteric Ischaemia ◽  
Buerger’S Disease ◽  
Buerger's Disease ◽  
Acute Mesenteric Ischaemia ◽  
Thrombangiitis Obliterans

Buerger‘s disease is an inflammatory occlusive disease which commonly involves medium-sized or smaller vessels of extremities. Mesenteric involvement in Buerger‘s disease is very rare. It can occur at any time during the course of the disease and presents with acute mesenteric ischaemia. In this study, a case of Buerger‘s disease with mesenteric involvement diagnosed before the onset of acute mesenteric ischaemia and managed endovascularly is reported.

scholarly journals Endovascular management of chronic mesenteric ischemia: a single centre experience in Western Rajasthan, India

2017 ◽  
Vol 5 (6) ◽  
pp. 2572
Author(s):  
Pawan Sarda ◽  
Goutam Kumar ◽  
Deepak Gupta ◽  
Sanjeev Sanghvi ◽  
Anil Baroopal
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Percutaneous Transluminal Angioplasty ◽  
Inferior Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Celiac Trunk ◽  
Transluminal Angioplasty ◽  
Chronic Mesenteric Ischemia ◽  
Percutaneous Transluminal

Background: Chronic mesenteric ischemia (CMI) or mesenteric angina is a condition characterised by inadequate blood supply to bowel as a result of stenosis affecting   one or more of the three mesenteric arteries: the celiac artery (CA), the superior mesenteric artery (SMA) and the inferior mesenteric artery (IMA).Methods: Ten patients with significant lesion, treated with PTA and stenting were selected for study and were followed at 2 weeks, at 2 months then at 6 months after index procedure to see composite of symptomatic improvement, weight gain and revascularization.Results: On mesenteric angiography, significant ostial stenosis of celiac trunk and superior mesenteric artery in 5 patients, 3 patients had significant ostial stenosis of celiac trunk and ostial stenosis of inferior mesenteric artery and 2 patients had significant stenosis of superior mesenteric artery. Percutaneous transluminal angioplasty (PTA) and stenting was done, final result was good and there was no residual stenosis and dissection. After stenting patients were stable and pain free. There were no post-operative complications. Follow up was done after 2 weeks and 2 months and then at six months. There was no postprandial abdominal pain on follow up and almost all patient had gained weight in 2 months and on 6 months of follow up, no case of repeat revascularization was recorded.Conclusions: Percutaneous transluminal angioplasty (PTA) and stenting to mesenteric artery is good alternative management of CMI. In present series, all cases were susses fully revascularized without residual stenosis and dissection.

Endovascular Treatment for Acute Mesenteric Ischaemia in a Young Woman with Polyarterial Disease

2017 ◽  
Vol 26 (1) ◽  
pp. 81-84
Author(s):  
Mihai C. Ober ◽  
Călin Homorodean ◽  
Dan A. Tătaru ◽  
Antonia E. Macarie ◽  
Camelia D. Ober ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Bowel Perforation ◽  
Computed Tomographic Angiography ◽  
Mesenteric Ischaemia ◽  
Acute Mesenteric Ischaemia ◽  
Computed Tomographic ◽  
Coeliac Trunk ◽  
Tomographic Angiography

Background: Acute mesenteric ischaemia is a condition with a grim prognosis on conservative treatment. Endovascular revascularisation is a promising approach for some of these patients.Case report: We present the case of a 44-year-old woman with a history of severe arterial hypertension, left leg claudication, and overlooked symptoms of chronic mesenteric ischaemia for one year, who was admitted for severe abdominal pain for one week. Computed tomographic angiography (CTA) showed acute mesenteric ischaemia by occlusion of the coeliac trunk and the superior mesenteric artery (SMA), without bowel perforation. In addition, CTA showed tight left renal stenosis and left external iliac stenosis. We performed angioplasty with a stent of the SMA, followed by revascularisation of the left renal artery. On control injection, the SMA appeared re-occluded, requiring a second stent implantation and a loading dose of dual antiplatelet therapy, with a good final result. Subsequently, the clinical course was uneventful, with no need of surgical exploration; a second procedure was planned, aiming at iliac revascularisation. At one month, the patient was asymptomatic, with normal Doppler flow in the SMA. Angiographic control during iliac revascularisation procedure showed a permeable SMA with a good filling of the coeliac trunk territory. Because of the suspicion of fibro-muscular dysplasia as aetiology, coronary angiography and cerebral CTA were performed, in order to exclude other potential lesions.Conclusions: Endovascular revascularisation in AMI is a promising alternative to the surgical approach in patients presenting without bowel perforation. Nevertheless, its safety and many tactical details remain to be clarified. Existing networks for revascularisation in acute myocardial infarction may be useful for the implementation of this approach.Abbreviations: AMI: Acute Mesenteric Ischaemia; CTA: Computed Tomographic Angiography; ICU: Intensive Care Unit; SMA: Superior Mesenteric Artery; STEMI: ST-segment Elevation Myocardial Infarction.

scholarly journals Morphological characteristics of the abdominal aorta

2013 ◽  
Vol 19 (3) ◽  
pp. 136-140
Author(s):  
G. Butoi ◽  
D.M. Iliescu ◽  
R. Baz ◽  
P. Bordei
Keyword(s):  
Superior Mesenteric Artery ◽  
Abdominal Aorta ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Morphological Characteristics ◽  
Celiac Trunk ◽  
Renal Arteries ◽  
Aortic Diameter ◽  
Transverse Diameter ◽  
Abdominal Aortic

Abstract The transverse diameter of the abdominal aorta was measured above the origin of the celiac trunk on a number of 82 cases, in male finding a caliber range of 18 to 31.8 mm, in one case, the aorta having a diameter of 31.8 mm. In females, the aorta was between 12.4 to 23.4 mm in caliber, most commonly, in 24 cases, being present a caliber range from 14.8 to 19.7 mm. At the level of the celiac trunk, on a number of 74 cases, the aorta had a diameter of between 12.9 to 28.6 mm in females and 11.4 to 21.8 mm in males. In males, on 20 cases, the caliber was 20 to 25 mm while in females, on 42 cases, we found a caliber range from 11.4 to 21.8 mm and in 20 cases being 19.4 to 2.18 mm. At the level of the superior mesenteric artery, we studied the aortic diameter on a number of 86 cases. In males it had a diameter between 12.9 to 26.4 mm, but in one case with 12.9 mm. In 26 cases, it had a diameter of between 20.1 to 26.4 mm. In females we found a range of 12.5 to 20.4 mm, most commonly with the diameter of 18-20 mm in 19 cases. Next to the renal arteries we studied the aortic diameter on a number of 118 cases, finding abdominal aortic diameters of 10.3 to 27.4 mm. In males it ranged from 10.9 to 27.4 mm diameter while in females had a diameter between 10.3 to 20.4 mm; in one case we met a caliber of 20.4 mm. The diameter of the abdominal aorta at the level of the inferior mesenteric artery was evaluated on 80 cases; in males the diameter ranged from 13.9 to 25.9 mm and in females was 10.6 to 19.3 mm.

Acute mesenteric ischaemia, a highly lethal disease with a devastating outcome

VASA ◽  
2006 ◽  
Vol 35 (2) ◽  
pp. 106-111 ◽  
Author(s):  
Safioleas ◽  
Moulakakis ◽  
Papavassiliou ◽  
Kontzoglou ◽  
Kostakis
Keyword(s):  
Mortality Rate ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Bowel Resection ◽  
Morbidity Rate ◽  
Time Interval ◽  
Mesenteric Ischaemia ◽  
Acute Mesenteric Ischaemia ◽  
Artery Embolism ◽  
Significant Difference

Background: Acute mesenteric ischaemia remains a serious condition requiring emergency surgical management. The mortality rate still remains high, due to the unspecific and delayed diagnosis and ranges from 59% to 100%. Purpose of our study is to present our experience in the management of the disease. Patients and methods: This is a retrospective study of 61 patients treated surgically for acute mesenteric ischaemia, between 1988 and 2004. All patients underwent a laparotomy. 75% of the patients were operated within the first 24 hours and the rest within 48 hours. Results: Superior mesenteric artery embolism occurred in 36 (59%), thrombosis in 21 (34%) and superior mesenteric vein thrombosis in 4 (7%) cases. In 49 (80%) cases, embolectomy or thrombectomy of the superior mesenteric artery with resection of the necrotic segment of the bowel was performed. Twelve cases (20%) were considered inoperable because of massive bowel necrosis. According to our study mortality and morbidity rate amounts to 75% and 80% respectively. No significant difference in the mortality rate between patients with embolism (75%) and thrombosis (76%) was found. However a significant increase of mortality rate was observed when the surgical intervention became afterwards the first 24-hour period. (72% versus 87%). Patients who underwent embolectomy or thrombectomy with bowel resection presented an improved survival rate compared with patients that underwent only bowel resection. (p = 0.019) Conclusions: Acute mesenteric ischaemia has the characteristics of a highly lethal condition and only early recognition and appropriate treatment can reduce the potential for a devastating outcome. The reduction of time interval from the beginning of symptoms up to the treatment remains the main critical important factor.

Sign in / Sign up

Export Citation Format

Share Document