ENDOVASCULAR TREATMENT OF CHRONIC MESENTERIC ISCHEMIA - REPORT OF 5 CASES

Purpose: To evaluate the midterm results of percutaneous transluminal angioplasty (PTA) and stent placement in stenotic and occluded mesente ric arteries in five consecutive patients with chronic mesenteric isch emia. Methods: Five patients with 70%-100% obliterations of all mesent eric vessels resulting in chronic mesenteric ischemia (n = 4) and as a prophylactic measure prior to abdominal aortic aneurysm repair (n = 1 ) underwent PTA of celiac and/or superior mesenteric artery (SMA) sten oses (n = 2), primary stenting of ostial celiac occlusions (n = 2), an d secondary stenting of a SMA occlusion (n = I; recoil after initial P TA). All patients underwent duplex ultrasonography (US) (n = 3) and/or angiography (n = 5) during a median follow-up of 21 months (range 8-4 2 months). Results: Clinical success was obtained in all five patients . Asymptomatic significant late restenoses (n = 3) were successfully t reated with repeat PTA (n = 2) and stenting of an SMA occlusion (n = 1 ; celiac stent restenosis). Recurrent pain in one patient was interpre ted as secondary to postsurgical abdominal adhesions. Two puncture-sit e complications occurred requiring local surgical treatment. Conclusio ns: Endovascular techniques may be attempted prior to surgery in cases of stenotic or short occlusive lesions in patients with chronic mesen teric ischemia. Surgery may still be preferred in patients with long o cclusions and a low operative risk.