PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY IN THE TREATMENT OF CHRONIC MESENTERIC ISCHEMIA - RESULTS AND 3 YEARS OF FOLLOW-UP IN 23 PATIENTS

Background: We evaluated the clinical efficacy of visceral angioplasty in the treatment of chronic mesenteric ischemia. Methods: Over a 14-y ear period, we performed percutaneous transluminal angioplasty of 41 o cclusive diseases of visceral arteries founded by angiography in 23 pa tients with chronic mesenteric ischemia. All but one (fibrodysplasic) stenoses were atherosclerotic, and 13 were localized in the ostial tra ct. Clinical follow-up was evaluated at 2, 6, 12, 24, and 36 months (m ean followup = 27 months). Results: Angioplasty demonstrated a residua l stenosis of 30% or less in 37 procedures, for a technical success ra te of 90%. Seventeen of 20 patients had symptom remission after the fi rst treatment, for a short-term clinical success of 77%; two patients needed a reangioplasty after 2 months, and one was referred for aortom esenteric bypass. During a mean follow-up of 27 months (range = 2-36), the clinical success was 88%; 2/15 patients underwent successful repe at angioplasty at 24 and 36 months, for a 100% secondary long-term cli nical success. Only two minor complications were encountered. Conclusi on: Although surgical results are undoubtedly positive, visceral angio plasty is justified in relation to both the high surgical mortality an d the low incidence of complications arising from visceral angioplasty .