Digestive Disease Interventions 2017; 01(S 04): S1-S20
DOI: 10.1055/s-0038-1641628
Oral Presentations
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA

Endovascular Treatment Approaches and Stent Patency in Chronic Mesenteric Ischemia

Sasan Partovi
1   Department of Radiology, Center for Interventional Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
,
Ziang Lu
2   Case Western Reserve University School of Medicine, Cleveland, Ohio
,
Indravadan J. Patel
1   Department of Radiology, Center for Interventional Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
,
Mohammed Al-Natour
1   Department of Radiology, Center for Interventional Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
› Author Affiliations
Further Information

Publication History

Publication Date:
22 March 2018 (online)

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    Purpose To describe the technique and assess the outcome of endovascular stenting for chronic mesenteric ischemia (CMI).

    Materials and Methods In this retrospective review, eight patients (all female, mean age 79.4 ± 12.2 years) with CMI undergoing endovascular mesenteric stenting were evaluated. Procedural characteristics including severity of mesenteric stenosis, procedural time, angioplasty, and stenting techniques, as well as post-angioplasty angiography results were recorded. Mesenteric stent patency and flow were also recorded on short-term follow-up imaging.

    Results The mean procedural time was 139.1 ± 50.1 minutes. On diagnostic cross-sectional imaging (seven computed tomography angiography [CTA] and one magnetic resonance imaging [MR]I) and angiography, all patients (100%) had severe stenosis in at least one mesenteric artery, five (62%) patients had severe stenosis in at least two mesenteric arteries, and one (13%) patient had severe stenosis in all three mesenteric arteries. Twenty-five percent of patients showed discrepancy in the degree of stenosis between cross-sectional imaging and angiography. A total of 11 mesenteric stents were placed, 5 (62%) had 1 stent placed (4 in superior mesenteric artery [SMA] and 1 in celiac artery [CA]), and in 3 (38%) patients stents were placed in 2 mesenteric arteries (CA and SMA) during the same procedure. The stent dimensions ranged from 5 × 18 mm to 8 × 29 mm. In one case, two 5 × 18 mm stents were used for the SMA. In all patients (100%), the final post-angioplasty and stenting angiography demonstrated complete resolution of stenosis with restoration of normal flow. Five patients (62%) had follow-up, ranging from 12 days to 5 months. All follow-up cross-sectional imaging studies demonstrated stent patency with unremarkable flow. A representative example is shown in the figure below.

    Conclusion Endovascular angioplasty followed by placement of balloon expandable stents is a safe endovascular technique for CMI treatment with a high technical success rate and favorable short-term stent patency. This procedural technique may serve as an attractive alternative to open surgery.

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    Fig. 1

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    No conflict of interest has been declared by the author(s).

     
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    Fig. 1