Percutaneous Stenting of the Superior Mesenteric Artery for the Treatment of Chronic Mesenteric Ischemia

ABSTRACT

PURPOSE: We wanted to evaluate the effectiveness of stent placement on the superior mesenteric artery as a treatment for chronic mesenteric ischemia. MATERIALS AND METHODS: Seven patients (mean age 55 years, age range 43-66 years) with chronic mesenteric ischemia were enrolled between March 2000 and September 2003. All the patients underwent pre-procedure contrast enhanced computerized tomography to evaluate for occlusion or stenosis of the mesenteric arteries and they then underwent an angiographic procedure. A balloon-expandable metal stent was placed in the superior mesenteric artery, and this was combined with balloon angioplasty and thrombolysis. We evaluated the angiographic and procedural success after the procedures. RESULTS: Angiographic and procedural success was obtained in 100% of the patients and the clinical symptoms improved in 100% of the patients. The patency at 6-months and 1-year was 85% and 71%, respectively. The mean follow-up period was 12 months (range 1-25 months). During the follow-up period, ischemic symptoms recurred in 2 patients, and restenosis in a stent was confirmed with angiography; one patient was successfully treated by stent placement in the celiac artery and the other patient died due to extensive mesenteric thrombosis. CONCLUSION: For the treatment of chronic mesenteric ischemia, percutaneuos stent placement on the superior mesenteric artery showed a favorable result and it was an effective alternative to surgery for the high-risk patients.