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Interventional Cardiology Clinics Apr 2020Atherosclerotic renal artery stenosis is the most common cause of secondary hypertension and may cause progressive renal disease and cardiac destabilization syndromes.... (Review)
Review
Atherosclerotic renal artery stenosis is the most common cause of secondary hypertension and may cause progressive renal disease and cardiac destabilization syndromes. Guideline-directed medical therapy is advised in all patients. Patients with refractory symptoms and hemodynamically significant stenoses are more likely to benefit from renal artery stent placement. Chronic mesenteric ischemia (CMI) is an infrequent and difficult to diagnose illness. Due to robust collateralization, clinical symptoms from mesenteric artery stenosis or occlusion is uncommon. Atherosclerosis is the most common etiology of CMI. Current evidence suggests that, compared with open surgical repair, endovascular therapy is the most cost-effective choice for CMI.
Topics: Computed Tomography Angiography; Humans; Mesenteric Arteries; Mesenteric Ischemia; Renal Artery; Renal Artery Obstruction; Stents; Vascular Surgical Procedures
PubMed: 32147118
DOI: 10.1016/j.iccl.2019.11.002 -
Surgery Aug 2022
Topics: Abdomen; Celiac Artery; Collateral Circulation; Humans; Mesenteric Arteries; Mesenteric Artery, Inferior
PubMed: 35277275
DOI: 10.1016/j.surg.2022.02.002 -
Journal of Vascular Surgery May 2014Mesenteric artery dissection was once thought to be rare but has been identified more frequently with increasing use of computerized tomographic angiographic imaging.... (Review)
Review
OBJECTIVE
Mesenteric artery dissection was once thought to be rare but has been identified more frequently with increasing use of computerized tomographic angiographic imaging. Multiple reports advocate a wide range of treatment including medical therapy, endovascular, and surgical intervention, with no clear guidelines for the application of each treatment.
METHODS
A systematic review of the literature was analyzed and used to create a treatment algorithm that was applied to nine patients in our institution.
RESULTS
Although medical therapy is adequate for most patients with mesenteric artery dissection, 14% failed medical therapy, sometimes with severe consequences. Asymptomatic status on presentation predicted successful medical therapy for superior mesenteric artery dissection (P = .0037).
CONCLUSIONS
Intensive surveillance is indicated during medical therapy, and invasive intervention may be necessary.
Topics: Adult; Aged; Aged, 80 and over; Algorithms; Aortic Dissection; Cardiovascular Agents; Critical Pathways; Endovascular Procedures; Female; Humans; Male; Mesenteric Arteries; Middle Aged; Patient Selection; Tomography, X-Ray Computed; Treatment Outcome; Vascular Surgical Procedures
PubMed: 24655752
DOI: 10.1016/j.jvs.2014.01.040 -
Diseases of the Colon and Rectum May 2005The aim of this study was to review the literature regarding collateral mesenteric circulation with emphasis on the mesenteric meandering artery (of Moskowitz). Standard... (Review)
Review
PURPOSE
The aim of this study was to review the literature regarding collateral mesenteric circulation with emphasis on the mesenteric meandering artery (of Moskowitz). Standard vascular embryology and anatomy are described as are the collateral mesenteric vessels that can develop with arterial stenosis or occlusion. A discussion on the correct usage of terms for describing mesenteric collateral vessels follows.
METHODS
We undertook review of the historical literature to discuss the surgical implications of the meandering mesenteric artery.
RESULTS
Despite a long history of study by anatomists and surgeons, confusion still persists regarding both the number and correct descriptive terminology of the collateral mesenteric vessels.
CONCLUSIONS
The use of the vague historic term "arc of Riolan" should be discarded for the more precise term "meandering mesenteric artery." The meandering mesenteric artery should routinely be preserved in all surgical procedures, to include resection for cancer, given its critical function in providing collateral mesenteric circulation. Further evaluation in the asymptomatic patient, however, is unnecessary.
Topics: Collateral Circulation; Gastrointestinal Diseases; Humans; Mesenteric Arteries; Splanchnic Circulation
PubMed: 15933893
DOI: 10.1007/s10350-004-0890-7 -
Journal of Vascular and Interventional... Dec 2019To retrospectively investigate factors associated with mesenteric artery remodeling after conservative management of isolated mesenteric artery dissection (IMAD)...
PURPOSE
To retrospectively investigate factors associated with mesenteric artery remodeling after conservative management of isolated mesenteric artery dissection (IMAD) (dissection of the mesenteric arteries in the absence of aortic dissection or other known causes).
MATERIALS AND METHODS
A total of 107 patients diagnosed with IMAD between February 2010 and October 2018 were identified. Eighteen patients were excluded because they underwent stent placement (n = 11) or were lost to follow-up (n = 7). A total of 89 patients who underwent conservative management were therefore included in the study. Cox regression analysis was performed to identify factors associated with mesenteric artery remodeling.
RESULTS
During 15.9 ± 10.9 months of follow-up, complete remodeling of the mesenteric artery was achieved in 66 patients (74.2%), and partial remodeling was achieved in 23 patients (25.8%). Of the 66 patients with complete remodeling, 6 (9.1%) had type IIa IMAD (visible false lumen, no visible re-entry site), and 60 (90.9%) had type IIb IMAD (thrombosed false lumen). The mean interval between IMAD diagnosis and complete remodeling was 14.4 ± 5.4 months for all patients. The mean intervals for patients with type IIa IMAD were 20.0 ± 6.2 months and 13.9 ± 5.1 months for patients with type IIb IMAD (P = .015). Mesenteric artery remodeling was significantly associated with the presence of symptoms (odds ratio, 10.800; 95% confidence interval, 1.961-59.470; P = .006).
CONCLUSIONS
Complete remodeling of the mesenteric artery in patients with IMAD treated with conservative management is common, and the presence of symptoms is associated with complete remodeling.
Topics: Adult; Aged; Aortic Dissection; China; Conservative Treatment; Female; Humans; Male; Mesenteric Arteries; Middle Aged; Retrospective Studies; Splanchnic Circulation; Time Factors; Treatment Outcome; Vascular Remodeling
PubMed: 31542276
DOI: 10.1016/j.jvir.2019.05.005 -
Journal of Investigative Medicine : the... Mar 2021The aim of this study is to evaluate the mesenteric artery stenosis (MAS) in routinely performed CT angiography (CTA) of patients with severe aortic stenosis (AS)...
The aim of this study is to evaluate the mesenteric artery stenosis (MAS) in routinely performed CT angiography (CTA) of patients with severe aortic stenosis (AS) planned for transcatheter aortic valve implantation (TAVI) before the procedure. Patients with AS (AS group) who routinely underwent CTA before the TAVI procedure due to severe AS and patients who had CTA for other indications (control group) were retrospectively and sequentially scanned. The demographic characteristics of the patients in both groups were similar. Calcification and stenosis in the mesenteric arteries were recorded according to the localization of celiac truncus, superior mesenteric artery (SMA) and inferior mesenteric artery (IMA). Class 0-3 classification was used for calcification score. Stenoses with a stenosis degree ≥50% were considered as significant. A total of 184 patients, 73 patients with severe AS and 111 control groups, were included in the study. SMA and IMA calcification scores of patients with AS were significantly higher than the control group (p=0.035 for SMA and p=0.020 for IMA). In addition, the rate of patients with significant MAS in at least 1 artery (45.2% vs 22.5%, p=0.001) and the rate of patients with significant stenosis in multiple arteries were also significantly higher in the AS group (8.2% vs 1.8%, p=0.037). According to the study results, patients with AS are at a higher risk for MAS. Chronic mesenteric ischemia should be kept in mind in patients with AS who have symptoms such as non-specific abdominal pain and weight loss.
Topics: Aortic Valve Stenosis; Computed Tomography Angiography; Constriction, Pathologic; Humans; Mesenteric Arteries; Retrospective Studies
PubMed: 33452127
DOI: 10.1136/jim-2020-001549 -
Surgical and Radiologic Anatomy : SRA Dec 2012In 114 cases of the transverse colon isolated from cadavers (50 male, 64 female), anatomical examinations of the arterial system of the colon were performed....
In 114 cases of the transverse colon isolated from cadavers (50 male, 64 female), anatomical examinations of the arterial system of the colon were performed. Arteriograms were obtained after dissecting and contrasting the colonic vessels with Mixobar contrast. In one case, on arteriography of the colon with its mesentery isolated from a 55-year-old male cadaver, a rare anatomical variant was found. The third mesenteric artery originated directly from the aorta-halfway between the superior and inferior mesenteric arteries and ascended obliquely in the direction of the hepatic flexure of the colon. Supply area of the artery was typical for the middle colic branch of the superior mesenteric artery: the distal segment of the ascending colon and the transverse colon. Such a variation, although very rare, may have particular impact on diagnosis and even the method and range of surgery.
Topics: Cadaver; Colon; Contrast Media; Female; Humans; Male; Mesenteric Arteries; Middle Aged
PubMed: 22820922
DOI: 10.1007/s00276-012-0987-y -
Journal of the College of Physicians... Jan 2022Null.
Null.
Topics: Aneurysm; Blood Vessel Prosthesis Implantation; Humans; Mesenteric Arteries; Mesenteric Artery, Superior
PubMed: 34983167
DOI: 10.29271/jcpsp.2022.01.128 -
Toxicologic Pathology Dec 2016Vascular injury can be induced by different classes of drug candidates, and it can affect the mesenteric vasculature. Sampling of the mesenteric vessels in the rat is...
Vascular injury can be induced by different classes of drug candidates, and it can affect the mesenteric vasculature. Sampling of the mesenteric vessels in the rat is crucial for proper assessment of potential adverse or pharmacologic effects of drugs in nonclinical rodent studies. To date, several sampling and processing techniques for the histopathologic evaluation of the mesenteric artery in rodents have been described and used in studies with candidate drugs that may affect the vascular system. However, most of those techniques require a significant amount of time and effort. A less labor-intensive, time-consuming, and expensive technique that allows examination of the mesentery vasculature with abundant longitudinal and cross sections of the vessels when examined microscopically was developed and presented here.
Topics: Animals; Drug Evaluation, Preclinical; Drug-Related Side Effects and Adverse Reactions; Female; Histological Techniques; Male; Mesenteric Arteries; Rats, Sprague-Dawley; Specimen Handling; Vascular Diseases
PubMed: 27604966
DOI: 10.1177/0192623316667245 -
Surgery, Gynecology & Obstetrics May 1987The origins of historical terms, such as "Arc of Riolan" and "marginal artery of Drummond" are traced herein with emphasis on the inherent confusion caused when these... (Review)
Review
The origins of historical terms, such as "Arc of Riolan" and "marginal artery of Drummond" are traced herein with emphasis on the inherent confusion caused when these terms are used. Basic mesenteric anatomy is briefly mentioned and pathologic anatomy with its altered direction of blood flow induced by atherosclerosis is stressed. The significance of the meandering mesenteric artery as the main collateral vessel between the superior and inferior mesenteric artery is emphasized along with preoperative and intraoperative ways to ascertain whether or not the origin of this latter vessel can be safely ligated. Specific operations, such as abdominal aortic aneurysmorrhaphy and sigmoid colectomy, which can potentially interfere with blood flow in the meandering mesenteric artery, are discussed in an attempt to prevent postoperative necrosis of any portion of the intestine that may have deficient mesenteric blood flow.
Topics: Blood Vessel Prosthesis; Celiac Artery; Collateral Circulation; Humans; Ligation; Mesenteric Arteries; Mesenteric Vascular Occlusion; Postoperative Complications; Saphenous Vein; Splanchnic Circulation
PubMed: 3554567
DOI: No ID Found