Persistent symptom relief after revascularization in patients with single-artery chronic mesenteric ischemia
Open accessAbstract
Objective An isolated stenosis of the celiac artery (CA) or the superior mesenteric artery (SMA) is frequently detected in patients with abdominal complaints. The dilemma is whether these patients suffer from chronic mesenteric ischemia (CMI) and whether they will benefit from revascularization. We evaluated the long-term clinical success rates for single CA or SMA revascularization in patients with gastrointestinal symptoms and confirmed mucosal ischemia. Methods This was a retrospective cohort analysis of 59 consecutive patients with gastrointestinal symptoms and a single atherosclerotic mesenteric artery stenosis who were referred to our tertiary care institution between 2006 and 2010 for standardized diagnostic workup of CMI, including measurement of mucosal ischemia with visible light spectroscopy or gastric-jejunal tonometry. Patients with multidisciplinary consensus diagnosis of CMI underwent surgical or endovascular revascularization. The primary outcome was clinical response to revascularization, defined as relief of presenting symptoms as experienced by the patient. Results Consensus diagnosis of CMI was obtained in 37 of 59 patients. Isolated CA stenosis was present in 30 of 37 patients (81%) and isolated SMA stenosis in seven patients. After a mean follow-up of 5.0 ± 3.0 years, 27 of 37 patients (73%) experienced sustained symptom relief after revascularization. Response was not related to lesion localization (CA, 73%; SMA, 71%; P = .919). Conclusions Revascularization of the CA or SMA provides persistent symptom relief in 73% of patients diagnosed with CMI due to single atherosclerotic mesenteric artery stenosis.
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Revascularisation has a higher clinical success rate in patients with multivessel disease (95.4%) compared with those with single vessel disease (69%).
“Revascularisation has a higher clinical success rate in patients with multivessel disease (95.4%) compared with those with single vessel disease (69%).”
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- Authors
- van Dijk, L. J. D., Moons, L. M. G., van Noord, D., Moelker, A., Verhagen, H. J. M., Bruno, M. J., & Rouwet, E. V.
- Affiliations
- University Medical Center Utrecht (NL)
- Erasmus MC (NL)
- Venue
- Journal of Vascular Surgery
- Publisher
- Elsevier BV
- Published
- 2018-09
- Volume
- 68
- Issue
- 3
- Pages
- 779-785
- ISSN
- 0741-5214 (ISSN-L)
- OpenAlex
- W2793498973
- Cited by
- 27
- References
- 39
- Citations by year
- 2025: 3 · 2024: 1 · 2023: 2 · 2022: 4 · 2021: 5 · 2020: 7 · 2019: 2 · 2018: 3
- FWCI
- 4.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Vascular Surgery (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Renal and Vascular Pathologies
- Keywords
- chronic mesenteric ischemia, celiac artery stenosis, superior mesenteric artery stenosis, mesenteric revascularization, endovascular revascularization, surgical revascularization, mucosal ischemia, visible spectroscopy, symptom relief, long-term clinical outcomes
- MeSH terms
- Aged, Celiac Artery, Chronic Disease, Female, Humans, Male, Retrospective Studies, Vascular Surgical Procedures, Treatment Outcome, Mesenteric Artery, Superior, Mesenteric Ischemia
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