Abdominal angina surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
For patients of abdominal angina with symptoms, surgery is the main treatment to relieve the symptoms and prevent intestinal infarction. There is no effective medical therapy exists for this disorder.
Surgery
The most common indication for treatment of abdominal angina is the presence of symptoms related to intestinal ischemia. Patients without symptoms do not constitute an indication for treatment. The main treatment for patients with abdominal angina is surgery.
- Surgery: The goal of surgery is to relieve the symptoms of abdominal angina and prevent intestinal infarction. Usual types of surgery include thrombectomy (removal of the obstructing lesion) and/or bypass of the obstructed portion of the blood vessel with an endogenous or prosthetic vascular conduit.[1]
- Adhesiolysis with transection of the median arcuate ligament is done for the treatment of Dunbar syndrome or Median arcuate ligament syndrome[2]
- Endovascular surgery: During this procedure, an aortogram is performed at first. After the narrowed artery is identified, the doctor uses a guide wire across the narrowed portion of the artery under direct fluoroscopy, dilating the narrow portion by a balloon. If residual stenosis is more than 50% of the expected artery luminal, a stent is recommended to place a stent across the narrowed portion of the blood vessel.[3]
- Open surgery: This kind of surgery is appropriate for patients whose lesions are not amenable to endovascular management. Under general anesthesia, the arteriotomy is performed to the patient to open the artery, then followed by embolectomy and removal of atherosclerotic plaques.
References
- ↑ Michalik M, Dowgiałło-Wnukiewicz N, Lech P, Majda K, Gutowski P (2016). "Hybrid (laparoscopy + stent) treatment of celiac trunk compression syndrome (Dunbar syndrome, median arcuate ligament syndrome (MALS))". Wideochir Inne Tech Maloinwazyjne. 11 (4): 236–239. doi:10.5114/wiitm.2016.64070. PMC 5299080. PMID 28194242.
- ↑ Kotarać M, Radovanović N, Lekić N, Ražnatović Z, Djordjević V, Lekć D, Sagić D (2015). "Surgical treatment of median arcuate ligament syndrome: case report and review of literature". Srp Arh Celok Lek. 143 (1–2): 74–8. doi:10.2298/sarh1502074k. PMID 25845256.
- ↑ Sundermeyer A, Zapenko A, Moysidis T, Luther B, Kröger K (September 2014). "Endovascular treatment of chronic mesenteric ischemia". Interv Med Appl Sci. 6 (3): 118–24. doi:10.1556/IMAS.6.2014.3.4. PMC 4168733. PMID 25243077.
- ↑ Senechal Q, Massoni JM, Laurian C, Pernes JM (2001). "Transient relief of abdominal angina by Wallstent placement into an occluded superior mesenteric artery". The Journal of cardiovascular surgery. 42 (1): 101–5. PMID 11292915.
- ↑ Busquet J (1997). "Intravascular stenting in the superior mesenteric artery for chronic abdominal angina". Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery. 4 (4): 380–4. PMID 9418203.