Related Experiment Video
Updated: Apr 1, 2026
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Successful Treatment of Acute on Chronic Mesenteric Ischaemia by Common Iliac to Inferior Mesenteric Artery Bypass
D N Coakley1, F M Shaikh1, E G Kavanagh1
1Department of Vascular Surgery, University Hospital Limerick, Limerick, Ireland.
Insights
This case study shows successful treatment of chronic mesenteric ischemia using single-vessel revascularization of the inferior mesenteric artery (IMA) in a high-risk patient. This approach offers a viable alternative when standard multi-vessel revascularization is not feasible.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Cardiovascular Medicine
Background:
- Chronic mesenteric ischemia (CMI) is a rare, severe condition often caused by atherosclerotic disease in multiple mesenteric arteries.
- Standard treatment involves revascularizing both the celiac artery and superior mesenteric artery (SMA), but this is not always possible due to unreconstructable arteries or patient unfitness.
Purpose of the Study:
- To present a case of successful treatment for acute-on-chronic mesenteric ischemia in a high-risk patient.
- To demonstrate the efficacy of single-vessel revascularization of the inferior mesenteric artery (IMA) as an alternative treatment strategy.
Main Methods:
- A 72-year-old high-risk patient with unreconstructable SMA and celiac artery disease was treated.
- A common iliac to IMA reversed vein bypass was performed for single-vessel revascularization.
Main Results:
- The IMA bypass graft remained patent at two-year follow-up.
- The patient experienced sustained symptom relief and maintained her weight, indicating successful treatment.
Conclusions:
- Single-vessel revascularization of the IMA can be a successful and life-saving treatment for select patients with chronic mesenteric ischemia.
- This technique provides a valuable alternative when standard multi-vessel revascularization is not an option.
Abstract:
Chronic mesenteric ischaemia is a rare and potentially fatal condition most commonly due to atherosclerotic stenosis or occlusion of two or more mesenteric arteries. Multivessel revascularisation of both primary mesenteric vessels, the celiac artery and superior mesenteric artery (SMA), is the current mainstay of treatment; however, in a certain cohort of patients, revascularisation one or both vessels may not be possible. Arteries may be technically unreconstructable or the patient may be surgically unfit for the prolonged aortic cross clamping times required. Here we present a case involving a 72-year-old woman with acute on chronic mesenteric ischaemia. She was a high risk surgical patient with severe unreconstructable stenotic disease of the SMA and celiac arteries. She was successfully treated with single vessel revascularisation of the inferior mesenteric artery (IMA) via a common iliac to IMA reversed vein bypass. At two-year follow-up, the graft remains patent and the patient continues to be symptom-free and is maintaining her weight.
