Endovascular Therapy for Chronic Mesenteric Ischemia

被引:10
作者
Foley T.R. [1 ]
Rogers R.K. [1 ]
机构
[1] Division of Cardiology, University of Colorado Hospital, University of Colorado School of Medicine, Aurora, CO
关键词
Chronic mesenteric ischemia; Multivessel atherosclerotic disease; Vascular disease;
D O I
10.1007/s11936-016-0463-9
中图分类号
学科分类号
摘要
Chronic mesenteric ischemia (CMI) most commonly occurs as a consequence of multivessel atherosclerotic disease of the mesenteric vasculature. Risk factors include smoking, hypertension, dyslipidemia, and advanced age, and women are more commonly affected than men. The clinical presentation of CMI is characterized by postprandial abdominal pain and weight loss. Left untreated, patients often develop severe malnutrition. Current consensus guidelines recommend secondary prevention medications such as statins and aspirin for all patients with known atherosclerosis to reduce the risk of stroke and MI, but data specific to medical therapy in CMI are lacking. To date, no medical therapy has been proven to be effective in preventing the progression of mesenteric atherosclerosis. Revascularization through surgical bypass is associated with significant perioperative morbidity and mortality. The evolution of endovascular techniques and equipment has made catheter-based therapy a first-line option for revascularization in CMI. © 2016, Springer Science+Business Media New York.
引用
收藏
相关论文
共 42 条
[1]  
Shah A.S., Schwartz L.B., Moawad J., Gewertz B.L., Technique profile: mesenteric reconstructions for occlusive disease, Expert Rev Cardiovasc Ther, 13, 12, pp. 1445-1458, (2015)
[2]  
Lee J.J., Mills J.L., Chronic mesenteric ischemia from diaphragmatic compression of the celiac and superior mesenteric arteries, Ann Vasc Surg, 30, pp. e5-e8, (2016)
[3]  
Kougias P., El Sayed H.F., Zhou W., Lin P.H., Management of chronic mesenteric ischemia. The role of endovascular therapy, J Endovasc Ther, 14, 3, pp. 395-405, (2007)
[4]  
Pecoraro F., Rancic Z., Lachat M., Et al., Chronic mesenteric ischemia: critical review and guidelines for management, Ann Vasc Surg, 27, 1, pp. 113-122, (2013)
[5]  
Thompson C.A., Textbook of Cardiovascular Intervention, (2013)
[6]  
Kougias P., Huynh T.T., Lin P.H., Clinical outcomes of mesenteric artery stenting versus surgical revascularization in chronic mesenteric ischemia, Int Angiol, 28, 2, pp. 132-137, (2009)
[7]  
Karkkainen J.M., Saari P., Kettunen H.-P., Et al., Interpretation of abdominal CT findings in patients Who develop acute on chronic mesenteric ischemia, J Gastrointest Surg, 20, 4, pp. 791-802, (2016)
[8]  
van Petersen A.S., Kolkman J.J., Meerwaldt R., Et al., Mesenteric stenosis, collaterals, and compensatory blood flow, J Vasc Surg, 60, 1, pp. 111-119, (2014)
[9]  
Thomas J.H., Blake K., Pierce G.E., Hermreck A.S., Seigel E., The clinical course of asymptomatic mesenteric arterial stenosis, J Vasc Surg, 27, 5, pp. 840-844, (1998)
[10]  
Chandra A., Quinones-Baldrich W.J., Chronic mesenteric ischemia: how to select patients for invasive treatment, Semin Vasc Surg, 23, 1, pp. 21-28, (2010)