Occlusion Of Visceral Arteries Research Articles

Treatment of intestinal angina by percutaneous transluminal angioplasty of a superior mesenteric artery occlusion

A 47-year-old woman with intestinal angina due to multiple visceral artery occlusions was treated surgically but suffered early thrombosis of an aorta-to-superior mesenteric artery (SMA) bypass graft and the return of her symptoms. Percutaneous transluminal angioplasty (PTA) of the occluded native origin of the SMA was successful. Three months later she is well and gaining weight. Several series of patients treated by PTA of superior mesenteric artery stenoses have been published, but to our knowledge this is the first report of the successful application of the technique to a complete SMA occlusion.

Surgical repair of visceral artery occlusions in Takayasu's disease

We describe the surgical management of six patients with occlusive disease of the visceral arteries caused by Takayasu's arteritis. All patients suffered from renovascular hypertension and, in addition, three of the patients also had symptoms of mesenteric angina. Surgical repair is recommended in the “burn-out” phase of the disease when further progression of the disease is unlikely. Revascularization of the kidneys was by autotransplantation to the iliac vessels. Mesenteric or celiac artery inflow was provided by an extra-anatomic vein bypass graft from the iliac artery. In all cases distal disease-free vessels were available for reconstructive surgery.

Value of lateal abdominal aortography.

The value of the routine lateral aortogram obtained during the contrast material injection for the frontal angiogram is stressed. This application of the basic radiographic principle of recording structures or events in more than one plane has resulted in the following:1. Detection of completely unsuspected visceral artery stenosis or occlusion. This has been of value in determining the cause of symptoms under investigation or in documenting the potential cause of subsequent disease.2. Determination of the extent of visceral artery stenosis where its presence is already suspected.3. Recognition of visceral artery stenosis and occlusion in the frontal aortogram. This is derived from a more complete understanding of the contrast flow pattern and the recognition of post-stenotic dilatation.4. More complete evaluation of aortic aneurysms as to size, extent of thrombosis, associated stenotic or occlusive visceral artery changes and relationship to the visceral arteries.5. Recognition of potentially hazardous v...

Experimental bowel ischemia.

INTESTINAL ischemia can be caused by a variety of vascular and hemodynamic abnormalities. One of these is narrowing or occlusion of the arterial system, which may involve large branches of visceral arteries or small extramural and intramural arterioles. The clinical and pathological manifestations of acute and chronic large artery occlusion in both humans and animals have been studied repeatedly.^1-21Far fewer investigations of small visceral artery occlusion have been published.^22-24Furthermore, in the majority of investigations, no long-term studies were carried out. Most frequently occlusion or narrowing of the arterial supply was produced surgically during laparotomy.^25-32Unless special techniques are used, it is difficult to examine a large number of small arterioles macroscopically and microscopically. One method for visualizing arterioles in the wall of the bowel is transillumination. A radiological technique is microangiography by which a radiopaque material is injected during dissection. Both techniques require the resection

Abdominal Angina

Abdominal angina that is characterized by postprandial pain, and often associated with weight loss, is a well-recognized symptom complex of mesenteric artery insufficiency (mesenteric territory symptoms). In the past 5 years, we have observed six patients with atypical symptoms who had mesenteric artery occlusion combined with stenosis or occlusion of the celiac artery. Atypical symptoms included severe nausea and vomiting at the sight or smell of food, anorexia, weight loss, and right upper quadrant or epigastric discomfort (celiac territory symptoms). An extensive work-up to rule out gastric, pancreatic, biliary, or colonic pathology was undertaken in these patients. The findings included gallbladder dysfunction, diffuse micro-ulceration of gastric mucosa, and colonic mucosal ulceration. The diagnosis of visceral artery occlusion was initially missed in all six patients. Four patients had cholecystectomy. Visceral angiography confirmed occlusion of the celiac, superior, and inferior mesenteric arteries. Five patients had dramatic resolution of symptoms after restoration of visceral circulation. One patient who developed intestinal infarction before revascularization died. Symptoms suggesting upper abdominal visceral pathology may be a manifestation of celiac artery stenosis/occlusion coexisting with mesenteric artery occlusive disease. Visceral angiography should be part of the work-up in these patients for early diagnosis and prompt management.

THROMBOTIC OCCLUSION OF THE ABDOMINAL AORTA

THROMBOTIC OCCLUSION OF THE ABDOMINAL AORTA ASSOCIATED VISCERAL ARTERY LESIONS AND COLLATERAL CIRCULATIONKLAUS M. BRON, M.D.Audio Available | Share

PERIPHERAL RESISTANCE RESPONSE TO OCCLUSION OF VISCERAL ARTERIES.

AbstractIn order to compare the effect of visceral and carotid sinus hypotension on the resistance vessels the peripheral resistance in 3 areas (hind body, kidneys and head) in the cat has been investigated by means of the constant perfusion rate technique during occlusion and desocclusion of visceral (coeliac, superior mesenteric and renal) arteries and of the carotid arteries. In all 3 areas clamping of the visceral arteries provoked a vasodilatation whereas a vasoconstriction in the hind body and kidney was observed during carotid artery occlusion. The clampings always produced significant rises in the general arterial blood pressure. The pressor response caused by visceral artery occlusion thus is produced in spite of a widespread dilatation of the resistance vessels—not as a consequence of a constriction in the same vessels. Denervation of the carotid sinuses plus section of the vago‐sympathetic trunks nearly always abolished the vasodilatation. Stabilising the blood pressure by means of a compensating device always abolished the vasodilatation during visceral artery occlusion. Under these circumstances the vasodilatation was not replaced by a vasoconstriction in the periphery. It has thus not been possible to demonstrate baroreceptor activity in the visceral arteries even under circumstances where the activity of the sino‐cardio‐aortic baroreceptor reflexes was eliminated.

HEART RATE AND BLOOD PRESSURE RESPONSE TO OCCLUSION OF VISCERAL ARTERIES.

AbstractIn experiments on cats the heart rate response to occlusion of the visceral and carotid arteries has been investigated. Of 69 combined or separate occlusions of the coeliac and superior mesenteric arteries 6 produced a tachycardia, in 9 no change in heart rate occurred, in the rest a bradycardia occurred. Of 32 common carotid artery occlusions 2 produced a bradycardia, in 4 no change in heart rate was observed and in the rest a tachycardia was produced. The bradycardia during visceral artery occlusion is interpreted as a reflex elicited from the sinoaortic baroreceptors and caused by the rise in blood pressure. It is further observed that the pressure increments caused by visceral artery occlusion have a maximum at subnormal systemic pressures (between about 65 and 100 mm Hg). This is contrary to the blood pressure rise caused by carotid artery occlusion which as a rule is greater the greater the systemic pressure, in accordance with the threshold concept for the baroreceptors.Therefore, at low systemic pressures (below about 110 mm Hg) a higher response to combined occlusion of the coeliac and superior mesenteric arteries than to carotid artery occlusion is the rule, the opposite is the case at higher systemic pressures.

Blood Pressure and Renal Blood Flow Response to Occlusion of Visceral Arteries

ONNIS, MARIO M.D.; SHUMACKER, HARRIS B. JR. M.D.; BOUNOUS, GUSTAVO M.D. Author Information

Acute and chronic thrombosis of the mesenteric arteries associated with malabsorption; a report of two cases successfully treated by thromboendarterectomy.

THAT occlusion of the mesenteric artery may produce a variety of clinical pictures has long been recognized.1 2 3 4 The cases of atherosclerotic occlusion of visceral arteries that are presented below offer two new pieces of information: that intestinal ischemia may be associated with malabsorption; and that both the acute and the chronic forms of thrombosis of the mesenteric arteries are amenable to reconstructive surgery.Case ReportsCase 1. A 54-year-old man (M.G.H. 956936) was admitted to the hospital on January 28, 1957, because of progressive bilateral intermittent claudication in the calves, thighs and hips for 1 1/2 years. For a few . . .