Mesenteric Artery Disease
What is Mesenteric Artery Disease
Narrowing of the arteries (blood vessels) that supply the body’s stomach and intestines
There are two types
Acute mesenteric ischemia- sudden block typically caused by a clot and can be immediately life-threatening.
Chronic mesenteric ischemia- related to atherosclerosis with a slower onset over many years.
Three main arteries that supply blood to your small and large intestineknown as the Coeliac trunk; Superior Mesenteric Artery and the Inferior Mesenteric artery.
What Are the Causes of Mesenteric Artery Ischemia?
ACUTE – blood clotsuddenly blocks blood flow.
These clots often originate in the heart and are more common among patients with an irregular heartbeat or heart disease.
CHRONIC- atherosclerosis (hardening of the arteries)slows the amount of blood flowing
What are the Symptoms?
Acute – Sudden severe abdominal pain
CHRONIC- severe stomach pain 15–60 minutes after eating.
Pain may last for as long as 2 hours and
Recur with every meal
Nausea, vomiting, diarrhea or flatulence.
Fear of food (Food fright) may develop due to pain.
Unintentional Weight Loss
How is a Diagnosis made?
A computed tomography (CT) scan is the test of choice. A CTAngiogram creates detailed three-dimensional images of cross-sections of your body. These images can identify problems with your arteries or with your abdominal organs.
How is this Treated?
The goal of treatment -to re-open the artery to allow adequate blood flow to your intestine so it will work properly.
Must be accomplished before permanent damage is done.
IN ACUTE CASE
- Usually an emergency procedure since severe intestinal damage can occur rapidly.
- Open surgery- to remove clot and look for damage to the intestines and assess its viability
- Clot aspiration- new minimally invasive modality where clot is sucked out using negative pressure
- Thrombolytic therapy- to dissolve the clot , strong blood thinners given directly into the artery during an angiogram
IN CHRONIC CASE
- Minimally invasive endovascular treatment
- first-line approach in most instances
- Balloon angioplasty and stenting
- Bypass surgery- creates a detour around the narrowed or blocked section of the affected artery. To create the detour, one of your veins or a synthetic tube is used as a graft, sewn-in above and below the blocked area to restore adequate blood flow to your intestines.
- Follow a heart-healthy diet.
- Avoid smoking.
- Exercise regularly.
- Stay hydrated.
- Manage chronic medical conditions including diabetes, high blood pressure, kidney failure and heart disease.