Mesenteric Arterial Disease

What is Mesenteric Arterial Disease?

Mesenteric arterial disease occurs when there is a narrowing or blockage in any of the three mesenteric arteries that carry blood to the large and small intestines. If left untreated, the disease can cause abdominal pain after eating and progressive weight loss. If the blood flow to the intestines becomes severely blocked, the intestines could die.

Causes

• Hardening of the arteries (atherosclerosis) and plaque formation that narrows the blood vessels, along with atherosclerosis elsewhere in the body including the legs and heart
• Fibromuscular dysplasia (abnormal development of the lining in the walls of your the arteries)
• Vasculitis, which is caused by an abnormal immune response in the blood vessel wall
• Blood clots from the heart that block the mesenteric artery

Risk Factors

• The presence of atherosclerosis elsewhere in the body
• Smoking
• High cholesterol
• High blood pressure
• Heart-rhythm disorders
• A family history of blood clots or blockages in blood vessels

What are the Symptoms?

Chronic Mesenteric Arterial Disease

• Abdominal pain after eating
• Diarrhea
• Weight loss

Acute Mesenteric Arterial Disease

• Sudden, severe abdominal pain
• Vomiting
• Diarrhea, sometimes with blood

How is Mesenteric Arterial Disease Diagnosed?

• Blood tests: A blood test will look for high white blood cell counts and changes in the blood-acid level.
• Ultrasound, Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scanning: Images or pictures of the mesenteric arteries are taken (using sound waves, magnetic fields, or X-rays) to determine if there are any areas of blocked or narrow arteries to the intestines.
• Angiography: A catheter is inserted into an artery in the groin or arm and contrast (dye) is injected through the catheter while X-ray pictures are taken to show whether the arteries to the intestines are narrowed or blocked.

Treatment at UVA's Heart and Vascular Center

• Minimally Invasive Stenting or Balloon Angioplasty: Without the need for surgery, a balloon or a stent (a small metal scaffold) can be used to open up a narrowed or blocked artery to the intestines to improve blood flow to the intestines. These procedures have been performed at UVA for more than 25 years.
• Surgical Bypass or Removal of the Blockage: If the blockage is too severe to relieve with a balloon or stent, surgery is done to either remove the blockage or a graft (either a vein from elsewhere in the body or plastic) is placed to bypass the blockage.
• Blood Clot Removal: Sometimes a blood clot can be dissolved using medication or removed using a mechanical device. On occasion, the blood clot may need to be surgically removed.
• Combination Therapy: A combination of angioplasty, stenting and surgery is sometimes used by a team of UVA doctors to treat the patient.