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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic intestinal ischemia is rare because of the great capacity to form abundant collaterals. The experience with ten patients is discussed and the literature is reviewed. Diagnosis is easily missed because of the lack of specific symptoms. All but one of the patients showed the classical triad (postprandial pain, weight loss, epigastric bruit). The diagnostic value of endoscopy based on remarkable ischemic mucosal findings is stressed. These findings have not been described before. Most of the patients suffered from generalized atherosclerosis and therefore had a high operative risk. There was a considerable postoperative morbidity, but no postoperative mortality. In all patients long-term results were satisfactory. Vascular reconstruction is strictly indicated in case of intestinal angina, not only to diminish severe complaints, but also to prevent acute ischemic infarction. In our opinion there is no indication for prophylactic surgery in case of asymptomatic arterial stenosis or occlusion.
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PMID:Vascular reconstruction in intestinal angina. 652 35

Chronic intestinal ischemia is usually caused by atherosclerosis of the visceral branches of the abdominal aorta. It classically presents with severe postprandial abdominal pain, weight loss due to fear of eating, and altered intestinal motility. Aortography is the definitive diagnostic study and usually reveals occlusive disease of at least two major visceral vessels. Revascularization is indicated in symptomatic patients but should be undertaken in asymptomatic patients only when aortic reconstruction is indicated that would threaten intestinal collateral blood flow. Refinements in operative technique and perioperative management have improved the safety and effectiveness of visceral reconstruction procedures.
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PMID:Chronic visceral ischemia. An often overlooked cause of abdominal pain. 687 83

Chronic mesenteric ischemia (CMI) occurs in the presence of slowly progressive, long-standing stenoses of the visceral arteries secondary to atherosclerosis. Angioplasty and stenting are emerging as therapeutic alternatives to surgery in treating CMI. The transradial approach is an attractive alternative access for performing stenting in CMI at improved safety and ease. A case of CMI treated with stenting of the visceral arteries by both transradial and femoral approaches is presented here. The main difficulty in accessing the celiac and mesenteric arteries through the femoral approach is the angle between the aorta and these vessels, which often leads the operator to use multiple catheters. The main advantage of the radial approach (as well as the brachial one) is that it allows easy coaxial alignment of the catheter with the artery. The main problem is the inadequate length of the currently available catheters. The radial approach eliminates the risk for vascular complications and permits early ambulation.
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PMID:Transradial approach for percutaneous transluminal angioplasty and stenting in the treatment of chronic mesenteric ischemia. 1506 36

Chronic mesenteric ischemia is primarily a disease of the elderly, who have widespread atherosclerosis of the celiac, superior mesenteric, and inferior mesenteric arteries. Risk factors include smoking, vasculitis, fibromuscular dysplasia, and arterial dissection. Presented here are 2 cases of women under age 50 years burdened with this condition, owing primarily to advanced arteriosclerosis. These cases illustrate a need for increased awareness of mesenteric ischemia as a cause for postprandial abdominal pain in young patients with other stigmata of advanced arterial occlusive disease.
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PMID:Young women presenting with chronic mesenteric ischemia--two case reports. 1607 45

Chronic intestinal ischaemia is a relatively rare but very important clinical entity, which is caused by a reduction in the splanchnic blood flow, most often because of atherosclerosis. Intestinal angina is postprandial abdominal pain developing when the genuine and collateral vessels no longer are able to accommodate the postprandial increasing demand from the gastrointestinal tract and the liver. In addition, the clinical picture very often includes sitophobia and weight loss. In daily clinical practice, conventional angiography is considered as the gold standard, but ultra sonography, computerized tomography and magnetic resonance angiography are gaining momentum when investigating for chronic intestinal ischaemia. These methods depend on imaging of the stenotic vessels not taking into consideration the possibility of sufficient splanchnic perfusion in spite of severely stenotic or occluded vessels. Only a few papers address the physiological consequence of stenotic or occluded vessels - the lack of postprandial increase in splanchnic blood flow.
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PMID:Chronic intestinal ischaemia: diagnosis. 1800 64

Chronic mesenteric ischemia (CMI) is most likely caused by atherosclerosis and less frequently by external compression and vasculitis. Symptomatic CMI is an uncommon, potentially under-diagnosed condition caused by fixed stenoses or occlusion of, in most conditions, at least two visceral arteries. If only one of the three major bowel-providing arteries - the celiac trunk, and the superior and inferior mesenteric arteries - is affected, the patient is usually asymptomatic due to a tight collateral network. The only exception is the celiac artery compression syndrome which represents primarily a compression syndrome of celiac plexus nerves by the arcuate ligament in conjunction with a compression of the celiac trunk. CMI of atherosclerotic origin is associated with a high morbidity and mortality. During the last decade, endovascular revascularization has replaced surgical revascularization as the therapy of choice in most centers. This article reviews the most relevant clinical aspects of the disease and the current practice of diagnosis and treatment of CMI.
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PMID:Chronic atherosclerotic mesenteric ischemia (CMI). 2058 21

Chronic mesenteric ischemia is a rare condition, generally characterized by postprandial abdominal pain. Although chronic mesenteric ischemia accounts for only a small percentage of all mesenteric ischemic events, it can have significant clinical consequences. There are multiple etiologies; however, the most common cause is atherosclerosis. The diagnosis of chronic mesenteric ischemia requires a high clinical index of suspicion. An imaging study can confirm the presence of a stenosis or occlusion involving the mesenteric vessels in patients who are suspected of having chronic mesenteric ischemia. The diagnosis is usually late in its course due to the slow progression of disease and the abundance of mesenteric collaterals. Because of the extensive collateral network, usually at least two of the three visceral vessels need to be affected before patients develop symptoms. Treatment is necessary to avoid progression to bowel ischemia and infarction. Once a diagnosis of chronic mesenteric ischemia is made, treatment options include open surgical revascularization and endovascular revascularization.
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PMID:Chronic mesenteric ischemia: diagnosis and treatment. 2132 44

Mesenteric ischemia is classified as either acute or chronic. The former is a life-threatening emergency in which a sudden reduction in intestinal blood flow may ultimately result in bowel infarction. The most common causes are arterial embolism, arterial thrombosis, nonocclusive mesenteric ischemia, and mesenteric venous thrombosis. A high index of suspicion, early diagnosis and rapid intervention are necessary so that normal mesenteric perfusion is restored before fatal bowel infarction can occur. Chronic mesenteric ischemia is usually caused by stenotic or occlusive disease involving the proximal segments of the mesenteric arterial supply to the bowel, usually as a result of atherosclerosis. Intestinal angina is the classic presentation, defined as recurrent postprandial abdominal pain that subsides in 1 to 2 hours, with associated weight loss and aversion to food. When combined with the clinical presentation, physical examination, and laboratory data, imaging plays a key role in the diagnosis of either acute or chronic mesenteric ischemia. Recognition of pertinent imaging findings and various treatment options may aid in preventing the serious and possibly fatal sequelae that may occur in cases of mesenteric ischemia.
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PMID:Mesenteric ischemia. 2132 62

Chronic mesenteric ischemia (CMI) is most likely caused by atherosclerosis and less frequently by external compression, fibromuscular dysplasia and vasculitis. Symptomatic CMI is an uncommon, potentially under-diagnosed condition caused by fixed stenoses or occlusion of in most conditions at least two visceral arteries. If only one of the three major bowel providing arteries - the celiac trunk, the superior and inferior mesenteric arteries - is affected, the patient is usually asymptomatic due to a tight collateral network. Symptoms and clinical signs of CMI may vary from the classical triad of postprandial pain, weight loss and upper abdominal bruit to nonspecific symptoms thus frequently resulting in delayed diagnosis. Established non-invasive diagnostic means are duplex ultrasound or CT- and MR-angiography offering excellent three dimensional reconstruction of the vessel pathology facilitating the decision for the appropriate revascularisation strategy. During the last decade, despite higher restenosis rates endovascular revascularization has replaced surgical revascularization as therapy of choice in most centers. If untreated CMI of atherosclerotic origin is associated with a high morbidity and mortality. This manuscript reviews the most relevant clinical aspects of the disease and the current practice of diagnosis and treatment of CMI.
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PMID:Management of chronic atherosclerotic mesenteric ischemia. 2150 Jan 74

Chronic mesenteric ischemia (CMI) is the most common vascular disorder involving the intestines, however it is unusual in clinical practice. The redundancy of the visceral circulation with multiple interconnections between the superior mesenteric artery (SMA) and the inferior mesenteric artery (IMA) is the most likely explanation for the infrequent occurrence of CMI in clinical practice. Atherosclerosis is by the far the most common etiology of CMI. The increased utilization of diagnostic abdominal cross-sectional imaging has increased the recognition of atherosclerotic mesenteric stenoses. CMI is a clinical diagnosis, based upon symptoms and consistent anatomic findings. The classic setting for CMI is a female patient presenting with post-prandial abdominal discomfort that results in significant weight loss. Endovascular therapy with stenting has become the most common method chosen for revascularization having replaced open surgery with its associated morbidity and mortality.
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PMID:Chronic mesenteric ischemia: diagnosis and management. 2172 85


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