Related Experiment Video
Updated: Jul 3, 2026
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Splenic infarction complicating percutaneous transluminal coeliac artery stenting for chronic mesenteric ischaemia: a
John A Almeida1, Stephen M Riordan
1Gastrointestinal and Liver Unit, The Prince of Wales Hospital and University of New South Wales, Barker Street, Randwick, New South Wales, Australia. priyanair@ozemail.com.au
Insights
Coeliac artery stenting effectively treated chronic mesenteric ischaemia but caused splenic infarction due to plaque embolization. This rare complication highlights a novel cause of abdominal pain after vascular procedures.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Gastroenterology
Background:
- Chronic mesenteric ischaemia (CMI) causes abdominal pain, particularly in elderly patients with vascular disease risk factors.
- Surgical revascularization was the traditional treatment for CMI.
- Percutaneous angioplasty and stenting offer a safe alternative for high-risk CMI patients.
Purpose of the Study:
- To report a case of splenic infarction complicating coeliac artery stenting in a patient with CMI.
- To highlight a novel cause of post-procedure abdominal pain.
Main Methods:
- A case presentation of an 84-year-old woman with CMI symptoms.
- Diagnostic imaging revealed calcific stenoses in multiple mesenteric arteries.
- Coeliac artery angioplasty and stenting were performed.
Main Results:
- Successful dilatation of the coeliac artery stenosis was achieved.
- The patient developed splenic infarction hours after the procedure, attributed to calcific emboli.
- Abdominal pain resolved, and the patient remained asymptomatic at 2-year follow-up.
Conclusions:
- This is the first reported case of splenic infarction following coeliac artery stenting.
- Distal embolization of disrupted calcific plaque is the presumed cause.
- This complication represents a novel cause of abdominal pain in CMI patients post-intervention.
Introduction:
Chronic mesenteric ischaemia is an important cause of abdominal pain, especially in older patients with risk factors for vascular disease. Until recently, surgical revascularization procedures such as endarterectomy and aorto-coeliac or aorto-mesenteric bypass grafting were the only available treatment options for patients with chronic mesenteric ischaemia. Percutaneous angioplasty and stenting have recently been shown to be effective and safe alternatives to surgical revascularization in high-risk patients with chronic mesenteric ischaemia.
Case Presentation:
We report an 84-year-old woman with symptoms of chronic mesenteric ischaemia, including post-prandial abdominal pain and weight loss. Investigations demonstrated calcific stenoses at the origins of the celiac, superior mesenteric and inferior mesenteric arteries, along with nonocclusive calcification in the mid-splenic artery. Coeliac artery angioplasty and stenting was performed, resulting in excellent arterial dilatation at the stenotic point and distal filling of the coeliac and superior mesenteric arteries and their branches. Within hours of successful stenting of the coeliac artery, the patient developed severe left upper quadrant pain. Progress imaging demonstrated splenic infarction, likely as a result of calcific emboli dislodged from the calcified plaque at the origin of the celiac artery at the time of angioplasty and stenting. The left upper quadrant pain resolved after 8 days and the patient remains asymptomatic 2 years post-procedure.
Conclusion:
This is the first reported case of splenic infarction complicating otherwise successful coeliac artery stenting, presumably as a consequence of distal embolization of disrupted calcific plaque. This complication, occurring on a background of non-occlusive splenic arterial calcification, represents a novel cause of abdominal pain post-procedure.