Mesenteric Artery Stenting: Comprehensive Treatment Guide

Q: What is a mesenteric angiogram?

A mesenteric angiogram is a special X-ray of the blood vessels (arteries) in the abdomen to show where the artery is blocked or bleeding.

Mesenteric ischemia is a medical condition in which injury to the small intestine occurs due to insufficient blood supply. Acute mesenteric ischemia appears abruptly, while chronic mesenteric ischemia develops over time. The acute form of the disease often presents with sudden, severe abdominal pain and is associated with a high risk of death.

The chronic form usually presents more gradually with abdominal pain after eating, involuntary weight loss, vomiting, and fear of eating.

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What Is Mesenteric Ischemia?

Mesenteric ischemia occurs when narrow or blocked arteries restrict blood flow to the small intestine. Insufficient blood flow may permanently damage the small intestine. Sudden loss of blood flow to the small intestine (acute mesenteric ischemia) due to a blood clot requires immediate surgery.

Angioplasty or open surgery was used to treat chronic mesenteric ischemia. Chronic mesenteric ischemia that is left untreated may become acute, resulting in extreme weight loss and malnutrition.

Causes of Mesenteric Ischemia

Mesenteric ischemia can be classified into two main types based on the duration and underlying causes:

Acute Mesenteric Ischemia

Occurs suddenly due to a blood clot blocking a mesenteric artery.
Commonly associated with conditions like irregular heartbeats or heart disease.
This results in rapid loss of blood flow to the intestines, leading to severe abdominal pain and potential tissue damage.

Chronic Mesenteric Ischemia

It develops gradually due to atherosclerosis (hardening of arteries), which causes narrowing and hardening of blood vessels.
Plaque buildup reduces blood flow over time, affecting intestinal function.
Often manifests in older adults with risk factors such as smoking or diabetes.

What is a Mesenteric Angiogram?

A mesenteric angiogram is a diagnostic procedure used to examine the arteries supplying blood to the intestines. It involves inserting a catheter into a major artery (aorta) and guiding it to the intestinal arteries. Contrast dye is injected to make these arteries visible on X-ray images.

This test helps doctors identify leaks or blockages in these blood vessels. A radiologist performs mesenteric angiography with support from a radiographer and a radiology nurse.

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Procedure and Preparation of Mesenteric Angiogram

Preparation for Mesenteric Angiogram

Blood tests will check clotting and kidney function.
Eat normally, drink water, and adjust medications as directed.
Intravenous fluids may be given if kidney function is poor.
Wear a hospital gown and be transported to the X-ray department.

During the Mesenteric Angiogram Procedure

Lie on the X-ray table.
Local anesthesia will be injected into your groin.
You may feel pressure, but inform the radiologist if you feel pain.
A catheter is inserted into the groin artery guided by X-rays.
X-rays are taken while the dye is injected, possibly causing warmth.
Embolisation may be performed if needed.
After X-rays, the catheter is removed; a sealing device may be used.

If embolisation is followed by same-day surgery, a sheath may remain in the groin.

Risks of Mesenteric Angiogram

Leaky vessels may not always be visible on the angiogram.
Surgery might still be necessary if embolisation is not entirely successful.
Potential for bleeding around the groin post-procedure; monitored closely for 4 to 6 hours.
Rare but serious complications from severe bleeding may occur.
The contrast medium could temporarily affect kidney function, especially in those with existing kidney issues; a pre-procedure blood test is standard.
Allergic reactions to the X-ray dye are rare and usually manageable during the procedure.

Frequently Asked Questions

It is a special X-ray of the blood vessels (arteries) in the abdomen to show where the artery is blocked or bleeding.

A decrease in blood flow can permanently damage the small intestine. Sudden loss of blood flow to the small intestine (acute mesenteric ischemia) due to a blood clot requires immediate surgery.

The mesenteric arteries take blood from the aorta and distribute it to a large part of the gastrointestinal tract. Both the superior and inferior mesenteric arteries arise from the abdominal aorta.

Computed tomography is useful in the diagnosis of superior mesenteric artery syndrome and can provide diagnostic information, including distances between the superior mesenteric artery and the aorta and duodenal distention.

Ischemia is potentially reversible if the cause can be treated and flow restored. Therefore, intestinal infarction is a surgical emergency that requires rapid diagnosis and surgical removal of the unviable intestine.

Tests used to diagnose chronic mesenteric ischemia include: Mesenteric duplex ultrasound allows your doctor to see how blood is flowing through the mesenteric arteries and if there is any blockage.

Mesenteric embolization is an established treatment for lower gastrointestinal bleeding. This study aimed to determine the outcome of angiography and embolization and their influencing factors