Mesenteric artery disease in the elderly
Open accessAbstract
Purpose The purpose of this study was to estimate the population-based prevalence of mesenteric artery stenosis (MAS) and occlusion among independent elderly Americans. Method As part of an ancillary investigation to the Cardiovascular Health Study (CHS), participants in the Forsyth County, NC cohort had visceral duplex sonography of the celiac arteries and superior mesenteric arteries (SMAs). Critical MAS was defined by celiac peak systolic velocity >or=2.0 m/s and/or SMA peak systolic velocity >or=2.7 m/s. Occlusion of either vessel was defined by lack of a Doppler-shifted signal within the imaged artery. Demographic data, blood pressures, and blood lipid levels were collected as part of the baseline CHS examination. Participants' weights were measured at baseline and before the duplex exam. Univariate tests of association were performed with two-way contingency tables, Student t tests, and Fisher exact tests. Multivariate associations were examined with logistic regression analysis. Results A total of 553 CHS participants had visceral duplex sonography technically adequate to define the presence or absence of MAS. The study group had a mean age of 77.2 +/- 4.9 years and comprised 63% women and 37% men. Participant race was 76% white and 23% African-American. Ninety-seven participants (17.5%) had MAS. There was no significant difference in age, race, gender, body mass index, blood pressure, cholesterol, or low-density lipoproteins for participants with or without MAS. Forward stepwise variable selection found renal artery stenosis (P =.008; odds ratio [OR], 2.85; 95% confidence interval [CI], 1.31, 6.21) and high-density lipoprotein >40 (P =.02; OR, 3.03; 95% CI, 1.17, 7.81) significantly associated with MAS in a multivariate logistic regression model. Eighty-three of the 97 participants with MAS (15.0% of the cohort) had isolated celiac stenosis. Seven participants (1.3% of the cohort) had combined celiac and SMA stenosis. Five participants (0.9% of the cohort) had isolated SMA stenosis. Two participants (0.4% of the cohort) had celiac occlusion. Considering all participants with MAS, there was no association with weight change. However, SMA stenosis and celiac occlusion demonstrated an independent association with annualized weight loss (P =.028; OR, 1.54; 95% CI, 1.05, 2.26) and with renal artery stenosis (P =.001; OR, 9.48; 95% CI, 2.62, 34.47). Conclusion This investigation provides the first population-based estimate of the prevalence of MAS among independent elderly Americans. MAS existed in 17.5% of the study cohort. The majority had isolated celiac disease. SMA stenosis and celiac artery occlusion demonstrated a significant and independent association with weight loss and concurrent renal artery disease.
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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”
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- Authors
- Hansen, K. J., Wilson, D. B., Craven, T. E., Pearce, J. D., English, W. P., Edwards, M. S., Ayerdi, J., & Burke, G. L.
- Affiliations
- Wake Forest University Health Sciences (US)
- Wake Forest University (US)
- Corresponding author
- Hansen, Kimberley J
- Venue
- Journal of Vascular Surgery
- Publisher
- Elsevier BV
- Published
- 2004-07
- Volume
- 40
- Issue
- 1
- Pages
- 45-52
- ISSN
- 0741-5214 (ISSN-L)
- OpenAlex
- W2024914432
- Cited by
- 191
- References
- 3
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 2 · 2023: 5 · 2022: 9 · 2021: 11 · 2020: 6 · 2019: 10 · 2018: 9 · 2017: 12 · 2016: 14 · 2015: 8 · 2014: 9 · 2013: 7 · 2012: 16
- FWCI
- 4.37
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Vascular Surgery (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (n01hc085082-026, n01hc085081-021, n01hc085079-024, n01hc015103-009, n01hc085084-005, n01hc085085-011, n01hc085083-027, n01hc085080-026, n01hc085086-022, 5r01dk047414-04, n01hc035129-010)
- National Heart, Lung, and Blood Institute (N01-HC-85081, N01HC85085, N01HC-85083, N01HC15103, N01HC85082, N01 HC85086, N01HC85080, N01-HC85079, N01-HC85084, 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 › Pulmonary and Respiratory Medicine › Renal and Vascular Pathologies
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Keywords
- mesenteric artery stenosis, mesenteric artery occlusion, superior mesenteric artery, celiac artery, older adults, prevalence, renal artery stenosis, HDL cholesterol, Cardiovascular Health Study, risk factors, weight change, peak systolic velocity, Doppler ultrasound, race and sex differences
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Arteriosclerosis, Celiac Artery, Female, Humans, Male, Mesenteric Arteries, Mesenteric Vascular Occlusion, Cohort Studies, Weight Loss, Prevalence, Mesenteric Artery, Superior, Ultrasonography, Doppler, Duplex
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