1/22. Simultaneous surgical intervention to coronary artery disease, peripheral arterial disease and superior mesenteric artery stenosis.A patient, suffering from angina pectoris, claudicatio intermittens and postprandial abdominal pain underwent coronary and peripheral arteriographic examination; coronary arterial disease and aortoiliac occlusive disease was diagnosed. color Doppler ultrasonography revealed superior mesenteric artery stenosis. CABG with MIDCAB (minimal invasive direct coronary artery bypass) technique was performed together with aortabifemoral graft interposition and graft bypass to superior mesenteric artery and considerable success was obtained.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
2/22. Intravascular stent implantation of the celiac artery in the treatment of chronic mesenteric ischemia.We report a case of chronic mesenteric ischemia that caused abdominal angina and weight loss in an 80-year-old woman. A mesenteric angiogram revealed total occlusion of the superior mesenteric artery and 90% stenosis of the celiac and inferior mesenteric arteries. Balloon angioplasty of the celiac artery failed because of elastic recoil. A 15-mm Palmaz-Schatz stent was dilated to 6 mm in the proximal celiac artery with an excellent angiographic result and complete resolution of symptoms. A clinical, 1-year follow-up demonstrated success with no recurrence of pain. This case report illustrates the value of balloon dilatation and stent implantation in a patient with atherosclerotic narrowing of multiple abdominal visceral arteries.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
3/22. Transient relief of abdominal angina by Wallstent placement into an occluded superior mesenteric artery.A 56-year-old man presented with complete occlusion of the superior and inferior mesenteric arteries resulting in chronic mesenteric ischemia. After a minimal angioplasty a Wallstent was inserted across the superior mesenteric artery occlusion. This produced immediate clinical relief, with a successful angiographic result. Eight months later, an intrastent occlusion with acute bowel infarction was treated in emergency by saphenous vein bypass graft. Despite the death of the patient a few days later from a multivisceral failure syndrome, this method seemed to us feasible in treating a chronically occluded SMA in patients with high operative risk.- - - - - - - - - - ranking = 4keywords = angina (Clic here for more details about this article) |
4/22. Isolated superior mesenteric artery thrombosis: a rare cause for recurrent abdominal pain in a child.A 4-year-old boy was evaluated for recurrent abdominal pain and failure to thrive over a 1-year period in a pediatric subspecialty clinic. Results of the extensive workup mostly were unremarkable. Eventually, imaging studies of the abdominal aorta revealed an isolated thrombosis of the superior mesenteric artery trunk and compensatory hypertrophy of the inferior mesenteric artery. He had been having abdominal angina symptoms and fear of eating. A detailed family history suggested a possible hypercoagulable state. However, an extensive hematologic evaluation did not reveal a recognizable defect that could produce thrombotic events. He was treated by arterial graft bypass surgery and started on conventional anticoagulants. Several months later, he developed repeat, near-total thrombosis of the graft with recurrence of his symptoms. After balloon dilation of the graft and starting him on appropriate anticoagulant maintenance regimen, he had good symptom relief, and the graft remained patent. This presentation was unusually prolonged for the type of vascular problem identified. The possibility of vascular problems in children, therefore, should be considered. Unidentified cause of hereditary clotting tendency is another challenging aspect of this case.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
5/22. Primary antiphospholipid syndrome presenting with abdominal angina and splenic infarction.The antiphospholipid syndrome is an autoimmune hypercoagulability syndrome in which a wide variety of thromboembolic diseases may occur. Gastrointestinal manifestations associated with vascular occlusion include budd-chiari syndrome, hepatic and splenic infarction, pancreatitis, omental and intestinal infarction, and esophageal variceal bleeding due to portal vein thrombosis, but chronic mesenteric ischemia associated with mesenteric arterial thrombosis is very rare in this syndrome. We experienced a female patient with primary antiphospholipid syndrome with abdominal angina and splenic infarction associated with celiac trunk and mesenteric arterial thromboses. This is the first report describing chronic mesenteric ischemia and splenic infarction in a patient with primary antiphospholipid syndrome.- - - - - - - - - - ranking = 5keywords = angina (Clic here for more details about this article) |
6/22. Systemic amyloidosis: a rare presentation of mesenteric angina.A 64-year-old man presented with an eight-month history of increasing postprandial epigastric pain and a 15 kg weight loss. Computed tomography of the abdomen, panendoscopy and mesenteric angiography failed to explain the cause of the patient's mesenteric angina. Systemic amyloidosis involving intestinal small vasculature without larger arterial involvement was diagnosed at autopsy after the patient died of an asystolic cardiac arrest. Mesenteric angina without evidence of ischemic enteritis or pseudo-obstruction is a rare manifestation of amyloidosis.- - - - - - - - - - ranking = 6keywords = angina (Clic here for more details about this article) |
7/22. 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.- - - - - - - - - - ranking = 5keywords = angina (Clic here for more details about this article) |
8/22. Mesenteric angioplasty for chronic intestinal ischaemia.Mesenteric angina is a difficult diagnosis and surgical treatment carries a significant morbidity and mortality. In patients with stenotic mesenteric vascular disease angioplasty offers an alternative method of treatment. In six patients who underwent mesenteric angioplasty relief of symptoms was achieved in five. recurrence of symptoms associated with recurrent stenosis occurred in two patients and was remedied by re-dilation in one. Mesenteric angioplasty is a safe alternative to surgical revascularisation for mesenteric stenosis causing chronic intestinal ischaemia.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
9/22. Celiomesenteric trunk compression and absence of collateral vessels in the large intestine--a case report.The authors report the case of a rare mesenteric anomaly in a 71-year-old man who presented with a preexisting abdominal aortic aneurysm (AAA) and a progressive history of postprandial abdominal pain and 10-lb weight loss. aortography revealed a common celiomesenteric trunk, an absent middle colic artery, and a stenotic inferior mesenteric artery. At operation, neural fibers compressing the common celiomesenteric trunk were lysed, the AAA was repaired, and the inferior mesenteric artery was subjected to endarterectomy and then reimplanted. The patient remains well and free of symptoms 1 year after operation. This rare case demonstrates the many different causes of intestinal angina and its surgical relief.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
10/22. Side-to-side aorto-mesenteric anastomosis for management of abdominal angina.Abdominal angina and fear of eating are manifestations of mesenteric ischemia. This infrequent cause of abdominal pain was diagnosed in a 60-year-old female smoker. We performed a novel side-to-side aorto-mesenteric anastomosis for mesenteric revascularization, with good short-term (6 months) result.- - - - - - - - - - ranking = 5keywords = angina (Clic here for more details about this article) |
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