Mesenteric Ischemia

Treatment

At Mayo Clinic, you and your doctor discuss treatment options for chronic 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 eating healthy, exercising and smoking cessation are important parts of treatment.

Acute mesenteric ischemia is a medical emergency and requires immediate surgery.

Medication

Mayo Clinic doctors may prescribe drugs to lower your blood pressure and cholesterol. Antibiotics may be needed if swelling (colonic ischemia) is found in the large intestine (colon) during a colonoscopy. 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).

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. Surgical options include:

A mesenteric artery bypass restores blood flow to the intestines

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A mesenteric endarterectomy removes fat and cholesterol buildup (plaque) in the mesenteric arteries.

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• Angioplasty. Angioplasty is a minimally invasive procedure that opens narrowed arteries. During an angioplasty, your surgeon inserts a long, flexible tube (catheter) that has a balloon on its tip. 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.

Mayo Clinic doctors treat people who are at high risk for complications during open surgery, such as older people, using minimally invasive surgery.