Treatment of acute mesenteric ischemia by percutaneous transluminal angioplasty.

A 79-yr-old man with previously documented atherosclerotic vascular disease presented with acute abdominal pain, signs of peritoneal irritation, and guaiac-positive stool. A mesenteric arteriogram showed high-grade stenosis of the superior mesenteric artery with a pressure gradient of 70 mmHg and complete occlusion of the inferior mesenteric artery. Percutaneous transluminal angioplasty of the superior mesenteric artery was performed with immediate reduction of the pressure gradient, increase in vessel caliber, and relief of abdominal pain. The patient went on to complete recovery and remains pain-free 6 mo after discharge from the hospital. To our knowledge, this is the first report of percutaneous transluminal angioplasty used to treat acute mesenteric ischemia.