Endovascular recanalization of total occlusions of the mesenteric and celiac arteries

• Published in: Journal of vascular surgery 2012-06, Vol.55 (6), p.1674-1681
• Main Authors: Sharafuddin, Mel J., MD, Nicholson, Rachael M., MD, Kresowik, Timothy F., MD, Amin, Parth B., MD, Hoballah, Jamal J., MD, Sharp, William J., MD
• Format: Article
• Language: English
• Subjects: Aged; Arterial Occlusive Diseases - diagnosis; Arterial Occlusive Diseases - mortality; Arterial Occlusive Diseases - physiopathology; Arterial Occlusive Diseases - therapy; Biological and medical sciences; Celiac Artery - diagnostic imaging; Celiac Artery - physiopathology; Chi-Square Distribution; Constriction, Pathologic; Endovascular Procedures - adverse effects; Endovascular Procedures - instrumentation; Endovascular Procedures - mortality; Feasibility Studies; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Iowa; Ischemia - diagnosis; Ischemia - mortality; Ischemia - physiopathology; Ischemia - therapy; Life Tables; Male; Medical sciences; Mesenteric Arteries; Mesenteric Ischemia; Mesenteric Vascular Occlusion - diagnosis; Mesenteric Vascular Occlusion - mortality; Mesenteric Vascular Occlusion - physiopathology; Mesenteric Vascular Occlusion - therapy; Middle Aged; Other diseases. Semiology; Proportional Hazards Models; Recurrence; Retrospective Studies; Risk Assessment; Risk Factors; Stents; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Survival Analysis; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography, Doppler; Vascular Diseases - diagnosis; Vascular Diseases - mortality; Vascular Diseases - physiopathology; Vascular Diseases - therapy; Vascular Patency; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2011.12.013

Objective To evaluate our experience with the endovascular treatment of total occlusions of the mesenteric and celiac arteries. Methods We performed a retrospective review of endovascular stenting of 27 nonembolic total occlusions of the superior mesenteric artery (SMA) and celiac artery (CA) between July 2004 and July 2011 (26 patients, 16 females; mean age, 62 ± 13 years). A variety of demographic, lesion-related and procedure-related variables were evaluated for potential impact of technical success and patency. The follow-up protocol included clinical assessment, and color and spectral Doppler evaluation of the stented vessel(s). Results The clinical presentation was chronic mesenteric ischemia in 12 patients, acute mesenteric vascular syndromes in 10 patients, foregut ischemia/ischemic pancreatitis in three patients, and prior to endovascular repair of aortic aneurysm in one patient. The treated vessel was SMA in 22 procedures, CA in three, and both SMA and CA in one. Technical success was achieved in 23 of the 27 attempted recanalizations (85%). Three patients who failed the attempt underwent open bypass, and another one underwent retrograde recanalization and stenting of the SMA. Procedure success was only significantly related to patient age