Mesenteric Artery Disease Bypass Stenting

The mesenteric arteries supply blood to the large and small intestines. When one or more of the mesenteric arteries narrow or become blocked, blood flow is restricted and the intestines fail to get enough oxygen. This is called ischemia - an inadequate blood supply (circulation) to an organ due to blockage of blood vessels in the area. Symptoms can include severe abdominal pain. If the blockage worsens, tissues in the intestine may start to die due to lack of blood flow.

Treatment for Chronic Mesenteric Ischemia

The goal of treatment is to reopen the blocked mesenteric arteries to restore adequate blood flow to the intestines.

Bypass Surgery

In bypass surgery, the vascular surgeon bypasses the narrowed or blocked section of the artery by creating a new avenue for blood flow using either a vein from another part of the body (bypass graft) or a tube made from synthetic material. This creates a new path for blood to flow to the intestines. Mesenteric bypass is a major operation done through an incision in the abdomen. The procedure is done under general anesthesia. Following the bypass, the patient will be placed on antibiotics and closely monitored. Patients can expect to be in the hospital about one week after surgery. Return to normal functioning occurs after about a month.

Angioplasty and Stenting

In this procedure, sometimes performed at the time of the angiogram, the vascular surgeon inflates a small balloon inside a narrowed mesenteric artery. After widening the artery with angioplasty,the surgeon may insert a stent, a tiny metallic mesh tube that supports the artery's walls and keeps the blood vessels open.

Treatment for Acute Mesenteric Ischemia

Treatment for acute mesenteric ischemia is generally an emergency procedure because severe intestinal damage can develop over a short time. Thrombolytic agents and other clot-dissolving medications may be injected into blood vessels, frequently at the time of the angiogram. Sometimes, these medications can dissolve the clot. Otherwise, the vascular surgeon must remove the clot surgically, especially where intestinal damage is present. With acute mesenteric ischemia, some parts of the intestine may be damaged beyond repair and must also be removed.