[Treatment of celiac and mesenteric arteries stenoses with interventional radiologic techniques].

OBJECTIVE

To evaluate the safety and efficacy of the interventional techniques for management of celiac and mesenteric arteries stenoses.

METHODS

Eight patients with celiac artery (CA) or superior mesenteric artery (SMA) focal stenotic lesions were treated with percutaneous transluminal balloon angioplasty (PTA) and stent placement. CA stenosis was present in 2 patients, SMA stenosis was present in 4, and both CA and SMA were involved in 2 patients. Postprandial pain was present in 4 patients, an epigastric bruit was present in 5. All patients presented with weight loss averaging 8 kg. The causes of the stenoses were atheroscleroses in 7 patients, median arcuate ligament syndrome (MALS) involvement of the CA in 1 patient.

RESULTS

PTA and stent placement was technically successful in the 8 patients. Three patients underwent stent placement in CA, 5 patients in SMA. Seven patients were treated with 1 stent, one was treated with 2 stents. The post-procedural arteriograms showed good dilation of the stenotic lesions in all patients. The puncture site hematoma occurred in 2 patients without severe consequences. Complete alleviation of abdominal pain occurred in 5 patients, significant improvement in 2, and no improvement in 1 patient. At three months after the procedures, weights were regained in 6 patients. Clinical follow-up was available in all 8 patients, with a mean follow-up of 42 months (median 28 months, range 6 to 72 months). Follow-up Doppler ultrasound examinations showed normal flow patterns, without evidences of re-stenosis in the stenting arteries. Five patients remained asymptomatic, one patient had intermittent abdominal pain even the stenting SMA to be patent. Two patients respectively died of unrelated CA/SMA stenosis in 14 and 24 months after the treatment.

CONCLUSION

PTA and stent placement are safe and effective methods for treatment of chronic CA and SMA focal stenoses, especially useful for these patients with a high surgical risk.