At Mayo Clinic, you and your doctor discuss treatment options for mesenteric ischemia. The most appropriate treatment depends on the severity of your symptoms, the cause and extent of your artery blockage, and your other medical conditions. Lifestyle changes such as switching to a healthy diet, exercising and stopping smoking are important parts of treatment.
Acute mesenteric ischemia is a medical emergency and requires immediate treatment.
If you have rapidly progressing (acute) mesenteric ischemia or blood clots in your intestinal veins (mesenteric venous thrombosis) you may need drugs to help prevent blood clots (anticoagulants).
Interventional procedures and surgery
Once your doctor determines that your stomach pain is caused by blocked intestinal arteries, you may need surgery. Doctors at Mayo Clinic perform conventional and minimally invasive procedures to improve blood flow to your intestines. Options include:
Angioplasty (with or without stenting). Angioplasty is a minimally invasive procedure that opens narrowed arteries. This procedure is also called endovascular revascularization. During an angioplasty, your doctor inserts a long, flexible tube (catheter) that has a balloon on its tip and when inflated will open the narrowed blood vessel.
The surgeon usually places a small wire tube (stent) in your artery to keep it open. If you have a blood clot, your doctor may remove it during your angiogram.
- Mesenteric artery bypass. A bypass creates an alternate route for blood to flow around the narrowed or blocked artery. Your surgeon sews a substitute blood vessel (graft) to a main artery to restore blood flow.
- Mesenteric endarterectomy. In an endarterectomy, your doctor makes an incision in the large blood vessel that branches off your heart (aorta) to reach the mesenteric arteries and remove fat and cholesterol buildup (plaques) or the blood clot blocking the artery.
Specialists at Mayo Clinic generally recommend treatment for everyone with chronic mesenteric ischemia. Specific treatment depends on the extent of the blood vessel blockage and your overall health. Mayo Clinic's doctors' experience with mesenteric ischemia helps them tailor treatment to your condition.
May 09, 2015
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- Hall JB, et al. Mesenteric ischemia. In: Principles of Critical Care. 3rd ed. New York, NY: McGraw-Hill; 2005. http://accessmedicine.com. Accessed Feb. 28, 2015.
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- Greenberger NJ, et al. Mesenteric vascular disease. In: Current Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy. 2nd ed. New York, NY: McGraw-Hill; 2012. http://www.accessmedicine.com. Accessed Feb. 28, 2015.
- Golden, AK. Decision Support System. Mayo Clinic, Rochester, Minn. Feb. 18, 2015.
- Tallarita T, et al. Patient survival after open and endovascular mesenteric revascularization for chronic mesenteric ischemia. Journal of Vascular Surgery. 2013;57:747.
- Kanamori KS. Outcomes of reoperative open or endovascular interventions to treat patients with failing open mesenteric reconstructions for mesenteric ischemia. Journal of Vascular Surgery. 2014;60:1612.
- Ryer EJ, et al. Revascularization for acute mesenteric ischemia. Journal of Vascular Surgery. 2012;55:1682.
- Rajan E (expert opinion). Mayo Clinic, Rochester, Minn. April 28, 2015.
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