Percutaneous transluminal angioplasty in the treatment of chronic mesenteric ischemia: results and 3 years of follow-up in 23 patients

Background: We evaluated the clinical efficacy of visceral angioplasty in the treatment of chronic mesenteric ischemia. Methods: Over a 14-year period, we performed percutaneous transluminal angioplasty of 41 occlusive diseases of visceral arteries founded by angiography in 23 patients with chronic mesenteric ischemia. All but one (fibrodysplasic) stenoses were atherosclerotic, and 13 were localized in the ostial tract. Clinical follow-up was evaluated at 2, 6, 12, 24, and 36 months (mean followup = 27 months). Results: Angioplasty demonstrated a residual stenosis of 30% or less in 37 procedures, for a technical success rate of 90%. Seventeen of 20 patients had symptom remission after the first treatment, for a short-term clinical success of 77%; two patients needed a reangioplasty after 2 months, and one was referred for aortomesenteric bypass. During a mean follow-up of 27 months (range = 2-36), the clinical success was 88%; 2/15 patients underwent successful repeat angioplasty at 24 and 36 months, for a 100% secondary long-term clinical success. Only two minor complications were encountered. Conclusion: Although surgical results are undoubtedly positive, visceral angioplasty is justified in relation to both the high surgical mortality and the low incidence of complications arising from visceral angioplasty.