Percutaneous Stenting of the Superior Mesenteric Artery for the Treatment of Chronic Mesenteric Ischemia

Department of Radiology, Yongdong Severance Hospital, Yonsei University College of Medicine Department of Radiology, Yonsei University College of Medicine Department of Radiology, Kangwon National University Hospital Received February 28, 2008 ; Accepted April 30, 2008 Address reprint requests to : Sang Hyun Suh, M.D., Department of Radiology, Yongdong Severance Hospital, Yonsei University College of Medicine, 14692 Dogok-dong, Kangnam-gu, Seoul 135-270, Korea Tel. 82-2-2019-3510 Fax. 82-2-3462-5472 E-mail: [email protected] Purpose: We wanted to evaluate the effectiveness of stent placement on the superior mesenteric artery as a treatment for chronic mesenteric ischemia. Materials and Methods: Seven patients (mean age: 55 years, age range: 43-66 years) with chronic mesenteric ischemia were enrolled between March 2000 and September 2003. All the patients underwent pre-procedure contrast enhanced computerized tomography to evaluate for occlusion or stenosis of the mesenteric arteries and they then underwent an angiographic procedure. A balloon-expandable metal stent was placed in the superior mesenteric artery, and this was combined with balloon angioplasty and thrombolysis. We evaluated the angiographic and procedural success after the procedures. Results: Angiographic and procedural success was obtained in 100% of the patients and the clinical symptoms improved in 100% of the patients. The patency at 6-months and 1-year was 85% and 71%, respectively. The mean follow-up period was 12 months (range: 1-25 months). During the follow-up period, ischemic symptoms recurred in 2 patients, and restenosis in a stent was confirmed with angiography; one patient was successfully treated by stent placement in the celiac artery and the other patient died due to extensive mesenteric thrombosis. Conclusion: For the treatment of chronic mesenteric ischemia, percutaneuos stent placement on the superior mesenteric artery showed a favorable result and it was an effective alternative to surgery for the high-risk patients.