Clinical Course of Mesenteric Artery Stenosis in Elderly Americans
Abstract
BACKGROUND: To examine prospectively the relationship between stenosis or occlusion of the celiac and superior mesenteric arteries and symptoms of chronic intestinal ischemia in free-living elderly patients in the United States. METHODS: As part of an ancillary study to the Cardiovascular Health Study, participants in the Forsyth County (North Carolina) cohort underwent visceral duplex ultrasonography of the celiac and superior mesenteric arteries. Critical mesenteric artery stenosis (MAS) or occlusion was defined by Doppler flow ultrasound-derived criteria. Clinical outcomes were assessed at annual follow-up examinations and review of death certificates. Multivariate associations between the presence of MAS and all-cause mortality and adverse cardiovascular events were analyzed. Participants with MAS were contacted to determine the presence of symptoms consistent with chronic intestinal ischemia. RESULTS: Of 553 participants who underwent visceral duplex ultrasonography, 97 (17.5%) had disease of the celiac or superior mesenteric artery. At a mean follow-up of 6(1/2) years, 20 participants with MAS (20.6%) and 93 without MAS (20.4%) had died (relative risk, 1.01; 95% confidence interval, 0.66-1.55). No deaths were attributed to intestinal infarction. No association existed between the presence of MAS and prevalent cardiovascular disease, all-cause mortality, or adverse cardiovascular events. A questionnaire was completed by 71% of the surviving participants with MAS. No participant reported symptoms or weight loss consistent with chronic intestinal ischemia. CONCLUSIONS: Mesenteric artery stenosis was a common finding in free-living elderly patients. At long-term follow-up, the presence of asymptomatic MAS was not associated with death or adverse cardiovascular events. Participants with asymptomatic MAS by duplex ultrasonographic criteria did not experience intestinal infarction or develop chronic intestinal ischemia.
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A stenosis in a single mesenteric artery is found in up to 18% of the general population.
“Although a stenosis in a single mesenteric artery is found in up to 18% of the general population, the diagnosis of mesenteric ischaemia is rare. 13,14”
In patients with single vessel disease, the probability of progression to CMI and AMI is very low.
“In patients with single vessel disease, the probability of progression to CMI and AMI is very low.”
The long term risk of becoming symptomatic in patients with asymptomatic MAOD is low, even in patients with multivessel disease.
“Prophylactic revascularisation in patients with asymptomatic MAOD is controversial, and rarely performed, because the long term risk of becoming symptomatic is low, even in patients with multivessel disease whose prognosis is determined by events in other vascular territories, other comorbidities, and age.”
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- Authors
- Wilson, D. B., Mostafavi, K., Craven, T. E., Ayerdi, J., Edwards, M. S., & Hansen, K. J.
- Affiliations
- Wake Forest University Health Sciences (US)
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2006-10-23
- Volume
- 166
- Issue
- 19
- Pages
- 2095
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W2162754324
- Cited by
- 135
- References
- 2
- Citations by year
- 2026: 2 · 2025: 8 · 2023: 6 · 2022: 6 · 2021: 8 · 2020: 9 · 2019: 6 · 2018: 5 · 2017: 9 · 2016: 6 · 2015: 7 · 2014: 10 · 2013: 6 · 2012: 9
- FWCI
- 6.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- UCLA - Biblioteca de Ciencias de la Salud (submittedVersion)
- Funders
- National Institutes of Health (n01hc085079-024, n01hc015103-009, n01hc085086-022, 5r01dk047414-04, n01hc035129-010)
- National Heart, Lung, and Blood Institute (N01HC15103, N01 HC85086, N01-HC85079, N01HC35129)
- National Institute of Diabetes and Digestive and Kidney Diseases (1-R01-DK-47414)
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Renal and Vascular Pathologies
- Keywords
- mesenteric artery stenosis, celiac artery, superior mesenteric artery, chronic intestinal ischemia, intestinal infarction, all-cause mortality, cardiovascular events, older adults, Cardiovascular Health Study
- MeSH terms
- Aged, Aged, 80 and over, Female, Humans, Male, Mesenteric Arteries, Mesenteric Vascular Occlusion, Prospective Studies, Surveys and Questionnaires, Radiography, Risk Factors, Ultrasonography, Cohort Studies, Comorbidity, Proportional Hazards Models
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