scholarly journals Anatomic Revascularization of the Celiac Trunk and the Superior Mesenteric Artery

Aorta ◽  
2018 ◽  
Vol 06 (01) ◽  
pp. 041-042
Author(s):  
Murat Ugurlucan ◽  
Nihat Aksakal ◽  
Yilmaz Onal ◽  
Didem Oztas ◽  
Ufuk Alpagut
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Major Depression ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Celiac Trunk ◽  
Endovascular Techniques ◽  
Risks And Benefits ◽  
Severe Weight Loss

AbstractChronic atherosclerotic mesenteric ischemia is a debilitating disorder. It may cause postprandial abdominal pain leading to severe weight loss. Patients are usually emotionally affected with major depression. The disease can be treated with open surgical and endovascular techniques and both methods have individual risks and benefits. In this report, the authors present anatomical revascularization of the superior mesenteric artery and the celiac trunk.

scholarly journals Clinical implications of chronic mesenteric ischemia in elderly and senile patients

2020 ◽  
Vol 92 (2) ◽  
pp. 74-80
Author(s):  
A. I. Dolgushina ◽  
A. S. Kuznecova ◽  
A. A. Seljanina ◽  
V. V. Genkel ◽  
A. G. Vasilenko
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Celiac Trunk ◽  
Mesenteric Arteries ◽  
Chronic Mesenteric Ischemia ◽  
Clinical Criteria

Aim.To evaluate the sensitivity and specificity of the clinical criteria for the diagnosis of chronic mesenteric ischemia in elderly and senile patients with mesenteric atherosclerosis. Materials and methods.The study included 142 patients (82 men and 60 women). The median age of patients is 66.0 [62.0; 72.0] years. Results.According to MDCT atherosclerotic lesions of the abdominal aorta and its unpaired visceral branches were diagnosed in 105 (73.9%) patients. A combination of atherosclerosis of the celiac trunk and the superior mesenteric artery with the presence of hemodynamically insignificant stenosis was revealed. Hemodynamically significant atherosclerotic narrowing of at least one mesenteric artery was present in 15% of cases. Among them, a single vascular lesion was found in 6 patients (4.2%), a combination of hemodynamically significant lesions of two arteries in 15 (11%) patients. Depending on the clinical manifestations, all patients are divided into two groups: the first group 30 (21.1%) patients with the presence of symptoms characteristic of chronic mesenteric ischemia (CMI). The second group consisted of 112 (78.8%) patients without a characteristic triad of symptoms. The clinical symptom complex of СMI, including postprandial abdominal pain, intestinal dysfunction and progressive weight loss, as a diagnostic criterion showed low sensitivity 13.3% and specificity 77.9%. At the same time, the sensitivity of such a clinical combination as a combination of atherosclerosis of the arteries of the lower extremities, weight loss and abdominal pain syndrome with a severity of more than 5.5 points, with respect to the detection of hemodynamically significant stenoses of two or more mesenteric arteries was sensitivity 86.7%, specificity 74.0%.

scholarly journals Percutaneous retrograde crossing of a near-occluded celiac trunk via the superior mesenteric artery as an adjuvant maneuver for antegrade stenting

2016 ◽  
Vol 15 (1) ◽  
pp. 61-65 ◽  
Author(s):  
Martin Andreas Geiger ◽  
◽  
Joren Callaert ◽  
Koen Deloose ◽  
Marc Bosiers ◽  
...  
Keyword(s):  
Weight Loss ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Celiac Trunk ◽  
Chronic Mesenteric Ischemia ◽  
Antegrade Approach ◽  
Progressive Weight Loss ◽  
Near Occlusion ◽  
Upper Abdominal

Abstract We describe the case of a 63-year-old woman with chronic mesenteric ischemia, persistent postprandial upper abdominal pain and progressive weight loss. Retrograde recanalization was performed via the superior mesenteric artery in order to achieve the goal of crossing the near-occlusion, showing that retrograde catheterization of the celiac trunk can be a feasible approach in challenging cases in which an antegrade approach fails as a single maneuver.

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.

Stenting of stenotic mesenteric arteries for symptomatic chronic mesenteric ischemia

VASA ◽  
2012 ◽  
Vol 41 (6) ◽  
pp. 425-431 ◽  
Author(s):  
Aschenbach ◽  
Bergert ◽  
Kerl ◽  
Zangos ◽  
Neumeister ◽  
...  
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Gastrointestinal Bleeding ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Celiac Artery ◽  
Lower Gastrointestinal Bleeding ◽  
Mesenteric Arteries ◽  
Chronic Mesenteric Ischemia ◽  
Technical Failure

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. Patients and 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.

scholarly journals Acute Abdomen Resulting from Concurrent Thrombosis of Celiac Trunk and Superior Mesenteric Artery

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Savaş Bayrak ◽  
Hasan Bektas ◽  
Yigit Duzkoylu ◽  
Ayhan Guneyi ◽  
Ekrem Cakar
Keyword(s):  
Early Diagnosis ◽  
Superior Mesenteric Artery ◽  
Acute Abdomen ◽  
Gold Standard ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Standard Treatment ◽  
Celiac Trunk ◽  
Etiological Factor ◽  
Vascular Structures

Mesenteric ischemia is one of the most mortal diseases of the gastrointestinal system causing acute abdomen. In most of the patients, the etiological factor is the obstructive embolism or thrombosis of superior mesenteric artery. In the literature, there have been reports regarding also celiac trunk occlusion in rare situations. The gold standard treatment relies on early diagnosis. The originality of our report relies on the concurrent obstruction of both vascular structures.

An uncommon cause of abdominal pain and weight loss: the superior mesenteric artery syndrome

VASA ◽  
2014 ◽  
Vol 43 (2) ◽  
pp. 149-153 ◽  
Author(s):  
Yasemin Gunduz ◽  
Fatih Altintoprak ◽  
Kiyasettin Asil ◽  
Guner Cakmak
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Superior Mesenteric Artery Syndrome

scholarly journals Malrotation Induced Small Intestine Ischemia in an Adolescent

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Karadeniz Erdem ◽  
Atamanalp Selçuk Sabri
Keyword(s):  
Emergency Department ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Emergency Surgery ◽  
Mesenteric Artery ◽  
Duodenal Obstruction ◽  
Mesenteric Ischemia ◽  
Clockwise Rotation ◽  
Small Intestinal

Intestinal malrotation occurs if midgut does not complete or partially completes its 270° counter-clockwise rotation around the superior mesenteric artery during embryologic life. In general, it frequently manifests with vomiting due to duodenal obstruction and volvulus in the initial months of life, and it is very rare to manifest in the adulthood. A 20-year-old male patient who had severe abdominal pain, nausea, vomiting, and distention for one day was evaluated at the emergency department. On abdominal tomography “swirling appearance of structures around the superior mesenteric artery” was reported. CT appearance was considered compatible with a rotational anomaly. Emergency surgery was planned for the patient. In laparotomy, it was observed that an approximately 100 cm long small intestine segment was rotated around a band (Ladd) and ischemia was developed in this segment due to rotation of its mesentery. The rotation of the small intestinal mesentery was corrected by opening the bands. After the warm application to the intestinal mesenteric ischemia for a while, the color and the peristalsis of the intestines became normal. The patient was discharged on postoperative day 2 with suggestions.

scholarly journals Percutaneous retrograde revascularization of chronic occlusions of the superior mesenteric artery via collaterals of the celiac artery

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Wilhelm H. Kersjes ◽  
Alexander Hesse
Keyword(s):  
Abdominal Pain ◽  
Clinical Outcome ◽  
Superior Mesenteric Artery ◽  
Abdominal Aorta ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Celiac Artery ◽  
Chronic Mesenteric Ischemia ◽  
Technical Success ◽  
Chronic Total Occlusions

Abstract Purpose To evaluate the technical success of percutaneous retrograde revascularization of the superior mesenteric artery (SMA) via the celiac artery (CA) in patients with chronic mesenteric ischemia (CMI). Methods We performed a retrospective review of three patients with chronic total occlusions (CTOs) of the origin of SMA which were recanalized retrograde via collaterals of the CA after frustrating attempt of antegrade revascularization from the abdominal aorta in our institute between May 2019 and June 2020. Results All technical procedures of retrograde revascularization of CTOs of SMA via collaterals of the CA were successful. The clinical outcome resulted in a sustained resolution of abdominal pain in all cases. Conclusion Retrograde recanalization of SMA via collaterals from the CA seems to be a successful endovascular option for patients with CMI and a chronically occluded superior mesenteric artery when antegrade recanalization fails as far as it can be concluded from the small number of presented cases.

scholarly journals A clinical case of using ICG-technologies to evaluate the results of the superior mesenteric artery stenting in a patient with acute mesenteric ischemia

2020 ◽  
pp. 103-109
Author(s):  
A. G. Khitaryan ◽  
A. S. Murlychev ◽  
I. V. Bondarenko ◽  
S. A. Kovalev ◽  
K. S. Veliev ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Clinical Case ◽  
Acute Mesenteric Ischemia ◽  
Spiral Computed Tomography ◽  
High Tech ◽  
Spiral Computed

Introduction. Acute mesenteric ischemia is a rare, but extremely severe life-threatening condition with a mortality rate of 40 to 60%, despite the development of modern high-tech diagnostic and treatment methods. Unfortunately, acute mesenteric ischemia does not have any pathognomonic symptoms or highly specific laboratory and instrumental symptoms and manifests as abdominal pain syndrome, which makes it harder to differentiate diagnosis and results in a delay in taking appropriate therapeutic measures.Clinical case. This clinical case report describes a case of a 70-year-old patient who was admitted to the cardiology department after undergoing percutaneous coronary intervention due to acute myocardial infarction. On the third day, the patient developed severe diffuse abdominal pain and diarrhea. After the series of diagnostic measures have been performed, an acute impairment of mesenteric circulation was suspected and a decision was made to perform spiral computed tomography, which confirmed the presence of a thrombus in the superior mesenteric artery. The patient underwent X-ray endovascular thrombospiration, transluminal balloon angioplasty and stenting of the superior mesenteric artery. Due to the persistence of abdominal pain on the following day, the patient also underwent a diagnostic laparoscopy using ICG technologies to assess the presence and severity of ischemic and necrotic intestinal changes. After six months from the date of discharge, the patient continues to be followed-up by a cardiologist.Conclusions. The timely performance of spiral computed tomography in patients with suspected acute mesenteric ischemia in the vascular regimen, angiography, endovascular interventions to restore blood supply to the intestine and ICG control of perfusion is appropriate to improve the treatment outcomes of this category of patients.

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