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Percutaneous intervention of superior mesenteric artery stenosis in elderly patients
Neelima Penugonda1, Delair Gardi, Theodore Schreiber
1Department of Cardiology, Wayne State University, Detroit, Michigan, USA.
Insights
Stenting mesenteric arteries is a safe and effective treatment for chronic mesenteric ischemia (CMI) in elderly patients. This minimally invasive approach offers low morbidity and high success rates, making it a preferred option over open surgery.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Gastroenterology
Background:
- Chronic mesenteric ischemia (CMI) is an increasingly prevalent gastrointestinal disorder, particularly in older populations.
- CMI necessitates timely intervention to prevent severe complications such as bowel infarction and necrosis.
- Traditional open surgical revascularization carries significant risks, especially for high-risk elderly patients.
Purpose of the Study:
- To review and compare stent placement versus open surgical revascularization for treating CMI in elderly patients.
- To evaluate the efficacy and safety of endovascular techniques in managing superior mesenteric artery stenosis.
Main Methods:
- Systematic review of existing literature focusing on stent placement and open surgical revascularization for CMI.
- Analysis of clinical outcomes, including morbidity, mortality, and technical success rates for both treatment modalities.
Main Results:
- Catheter-based stent placement demonstrates low morbidity and high technical success rates in treating CMI.
- Endovascular therapy is particularly advantageous for elderly patients and those with high operative risks.
- Stenting offers a viable alternative to open surgery for superior mesenteric artery stenosis.
Conclusions:
- Stent placement in mesenteric arteries is established as a first-line therapy for CMI in select elderly patients.
- The minimally invasive nature and favorable outcomes of endovascular techniques support their widespread adoption for CMI management.
Abstract:
This review article focuses on stent placement in mesenteric arteries in older patients with an increasingly common diagnosis of chronic mesenteric ischemia (CMI). We reviewed the articles that focused on the treatment of this gastrointestinal disorder by stenting/open surgical revascularization to avoid further ischemic episodes and bowel infarction and necrosis. The advantages of stent placement in mesenteric arteries are discussed in comparison to open surgical revascularization. In summary, the low morbidity and high technical success rate of catheter-based techniques have made this approach the first line of therapy for CMI due to superior mesenteric artery stenosis for many elderly patients especially high-risk operative candidates.
