Scripps vascular surgeons provide routine and emergency care for people who have narrowed, blocked, or ballooning blood vessels in their abdomen called mesenteric veins and arteries. The group of medical conditions that can impact these blood vessels are collectively known as mesenteric vascular disease.
Because symptoms of mesenteric ischemia and other mesenteric disorders are similar to other medical conditions that cause abdominal distress, it’s important to seek care from specialists who are trained to pinpoint the exact cause of your symptoms and provide timely treatment. Scripps physicians have extensive experience diagnosing and treating mesenteric disease, including acute and chronic mesenteric ischemia, mesenteric venous thrombosis, and visceral artery aneurysm or dissection.
Scripps vascular surgeons provide expert care for people with conditions that affect the mesenteric arteries and veins.
The mesenteric arteries and veins are little-known but important vessels that carry blood to and from your large and small intestines. If these blood vessels become narrowed or blocked, blood cannot flow through them as easily and your intestines become deprived of necessary oxygen. A prolonged lack of oxygen can cause tissue in your intestines to die.
While mesenteric vascular disease is commonly caused by long-term plaque build-up or a blood clot that blocks the vessel, it can also occur in people who have other medical conditions including aortic dissection, congestive heart failure, fibromuscular dysplasia and narrowed or blocked veins in the bowel.
Scripps vascular surgeons provide thorough diagnosis and repair of several different forms of mesenteric vascular disease, including the following long-term and sudden medical conditions:
- Chronic mesenteric ischemia occurs when one or more of the mesenteric arteries is narrowed or blocked, depriving the intestines of oxygen. People with chronic mesenteric ischemia have experienced symptoms over a relatively long period of time.
- Acute mesenteric ischemia is a sudden blockage of one or more of the mesenteric arteries, which prevents blood and oxygen from reaching the intestines. Symptoms begin suddenly and progress rapidly, often requiring emergency treatment.
- Mesenteric venous thrombosis occurs when a blood clot blocks one of the mesenteric veins that carry blood away from the intestine. This causes blood to stop circulating in the intestine, and the resulting lack of oxygen leads to tissue death.
- Visceral artery aneurysms occur when one of the arteries that supply blood to the spleen, kidneys, liver or intestines, begins to bulge and potentially burst. Scripps vascular surgeons provide conventional and minimally-invasive repair of any visceral artery aneurysm, including splenic artery aneurysms and renal artery aneurysms.
- Visceral artery dissections occur when there is a rip or tear in a visceral artery wall (the visceral arteries carry blood to the spleen, kidneys, liver or intestines). Scripps physicians are trained to diagnose and treat different forms of visceral artery dissection, including superior mesenteric arterial (SMA) dissection and renal artery dissection.
People with mesenteric vascular disease typically experience pain and other symptoms in their abdomen. Depending on your particular medical condition, these symptoms may gradually get worse over time, or they may come on suddenly and quickly worsen:
- Intense pain in your abdomen that occurs between 15 and 60 minutes after eating. While the pain typically goes away after 60-90 minutes, it usually returns after each meal.
- Weight loss
- Nausea and/or vomiting
Risk factors for mesenteric disease include:
- Family history of vascular disease
- Age (60 and older)
- Tobacco use
- High blood pressure
- High cholesterol
Scripps physicians can diagnose mesenteric disease using one or more of the following tests:
- Doppler ultrasound, an imaging study that evaluates blood flow through a blood vessel
- Mesenteric angiogram, a special imaging procedure that uses X-ray and a special dye to help doctors see inside the mesenteric arteries, which carry blood to the small and large intestines.
- Magnetic resonance angiography (MRA)
- Computed tomography (CT) scan
- Computed tomography angiography (CTA)
Our vascular surgeons perform the following open surgical and endovascular approaches for treating mesenteric vascular disease.
- Angioplasty and stenting is an endovascular procedure that uses a balloon-tipped catheter to first inflate a narrowed mesenteric artery or vein, and then place a tiny mesh cylinder called a stent to keep the blood vessel permanently propped open.
- Trans-aortic endarterectomy, a surgical procedure in which plaque is removed from a mesenteric artery so it is no longer narrowed or blocked.
- Arterial bypass surgery allows a vascular surgeon to create a detour around the narrowed or blocked portion of a mesenteric artery. This “bypass,” made from one of your own veins or from synthetic material, allows blood to reroute around the blockage and flow into the intestines.
- Thrombolysis is used to dissolve a blood clot by injecting clot-busting medication directly into the blocked mesenteric vein.