What Is Chronic Mesenteric Ischemia?
Chronic mesenteric ischemia is when blockages of the arteries to the intestines reduce blood flow to the point that there is not enough for proper food digestion. This leads to pain after eating (postprandial pain), weight loss, and fear of food. The main mesenteric (intestinal) arteries involved are the celiac and superior mesenteric arteries.
Left untreated over time, blockages can decrease blood flow to the point that the tissues in your intestines can die and cause an emergency.
Chronic mesenteric ischemia causes
Atherosclerosis (hardening of the arteries) causes chronic mesenteric ischemia.
Healthy arteries are flexible and smooth and allow blood to flow freely through them.
In atherosclerosis, fatty deposits and calcium can build up along the inner artery walls and form plaque. Over time, the buildup of plaque causes the arteries to narrow. This limits the amount of oxygen-rich blood that flows to the intestines.
Chronic mesenteric ischemia risk factors
Factors that increase your risk of chronic mesenteric ischemia include:
- Age, older than age 60
- Smoking
- High cholesterol levels
- Diabetes
Diagnosis of chronic mesenteric ischemia
Along with obtaining your history, your doctor may order tests to determine if the blood vessels to your intestines are narrowed and by how much. The main tests are mesenteric doppler ultrasound and CT angiogram of the abdomen. If the narrowing is severe enough on imaging, treatment may be required.
Treatment of chronic mesenteric ischemia
Catheter-based therapy
- Angiography: In catheter angiography, your IR doctor enters your arteries through the groin or wrist with wires and catheters. These catheters (small tubes) are used to get into the blood vessels to your intestines. Dye is injected with X-ray imaging to take pictures of the blood vessels and identify any narrowing.
- Angioplasty and Stenting: Angioplasty is a procedure done to restore blood flow through a blocked or narrowed artery. It involves the passage of a catheter with a deflated balloon at its tip into the artery. The balloon is then inflated to displace the plaque outwards. This restores the blood flow by widening the artery. In addition, a stent may be placed in the artery to keep it open after angioplasty is done.
- Angiography: In catheter angiography, your IR doctor enters your arteries through the groin or wrist with wires and catheters. These catheters (small tubes) are used to get into the blood vessels to your intestines. Dye is injected with X-ray imaging to take pictures of the blood vessels and identify any narrowing.
Surgical Therapy
Although it is very rare, some patients may require a surgical procedure to treat their chronic mesenteric ischemia. You will be referred to the appropriate physician if this is found to be necessary.
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