doiSerbia

Successful intestinal ischemia treatment by percutaneus transluminal angioplasty of visceral arteries in a patient with abdominal angina

Nenezić Dragoslav (Klinika za vaskularnu hirurgiju, Institut za kardiovaskularne bolesti „Dedinje”, Beograd)
Popov Petar (Klinika za vaskularnu hirurgiju, Institut za kardiovaskularne bolesti „Dedinje”, Beograd)
Tanasković Slobodan (Klinika za vaskularnu hirurgiju, Institut za kardiovaskularne bolesti „Dedinje”, Beograd)
Gajin Predrag (Klinika za vaskularnu hirurgiju, Institut za kardiovaskularne bolesti „Dedinje”, Beograd)
Matić Predrag (Klinika za vaskularnu hirurgiju, Institut za kardiovaskularne bolesti „Dedinje”, Beograd)
Kovačević Vladimir (Klinika za vaskularnu hirurgiju, Institut za kardiovaskularne bolesti „Dedinje”, Beograd)
Petrović Branko (Klinika za vaskularnu hirurgiju, Institut za kardiovaskularne bolesti „Dedinje”, Beograd)
Ilijevski Nenad (Klinika za vaskularnu hirurgiju, Institut za kardiovaskularne bolesti „Dedinje”, Beograd)

Introduction. Abdominal angina, also known as chronic mesenteric ischemia or intestinal angina, is a rare disease caused by intestinal flow reduction due to stenosis or occlusion of mesenteric arteries. A case of successful treatment of a patient with abdominal angina by percutaneous transuliminal angioplasty of high-grade superior mesenteric artery and coeliac trunk stenosis was presented. Case Outline. A 77-year-old male patient was admitted at our Clinic for severe postprandial abdominal pains followed by frequent diarrhoeas. Extensive gastrointestinal investigations were performed and all results were normal. Multislice computerized (MSCT) arteriography was indicated which revealed ostial celiac trunk and superior mesenteric artery subocclusion. Percutaneous transluminal angioplasty of the superior mesenteric artery and coeliac trunk was done with two stents implantation. Just a few hours following the intervention, after food ingestion, there were no abdominal pains. Six months later, the patient described a significant feeling of relief after food ingestion and no arduousness at all. Conclusion. High-grade visceral arteries stenoses in patients with intestinal ischemia symptoms can be treated by either surgical procedures or percutaneus transluminal angioplasty. In cases when a low operative risk is anticipated, surgical treatment is recommended due to a better anatomical outcome, while percutaneus angioplasty is advised to elderly patients in whom increased operative risks can be expected.

Keywords: chronic mesenterial ischemia, abdominal angina, mesenteric artery stenosis, coeliac trunk, percutaneous angioplasty