Chronic mesenteric ischaemia:: the importance of the individual mesenteric artery

Christian Høyer; Mette Høgh Christensen; Jes Sandermann; Robert Johannes Leusink; Jan Abrahamsen

doi:10.1111/cpf.12730

Chronic mesenteric ischaemia: the importance of the individual mesenteric artery

Christian Høyer^*, Mette Høgh Christensen, Jes Sandermann, Robert Johannes Leusink, Jan Abrahamsen

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

6 Citations (Scopus)

Abstract

Background: Chronic mesenteric ischaemia (CMI) is a vastly underdiagnosed condition that typically leads to postprandial abdominal pain and weight loss. The aim of the study was to explore the involvement of various mesenteric vessels in total splanchnic blood flow (SBF) and hepatic vein oxygenation. Methods: Single-blinded comparative trial of 476 patients clinically suspected of CMI. Routine investigation included measurement of hepatic vein oxygen saturation, indirect measurement of the total splanchnic blood flow (SBF), using Fick's principle and the tracer [ ^99mTc]Mebrofenin, before and after a meal, and digital subtraction angiography. Results: A total of 176 of the 476 patients (36%) had at least one angiographically significant stenosis (lumen reduction ≥70%). In patients with a significant one-vessel disease, the percentage having CMI according to SBF was 10% for a celiac trunk stenosis (n = 60), 50% for a superior mesenteric stenosis (n = 24) and 6% for an inferior mesenteric artery stenosis (n = 34). In patients with a significant two-vessel disease, the percentage with CMI according to SBF response was 92%, 18% and 79%, for no significant stenosis of the celiac trunk (n = 13), superior mesenteric artery (n = 17) and inferior mesenteric artery (n = 19), respectively. Conclusion: Patients with significant one- or two-vessel stenosis involving the superior mesenteric artery have a higher likelihood of CMI according to flow criteria and a greater postprandial decrease in hepatic vein saturation on average than patients with no involvement of the superior mesenteric artery.

Original language	English
Journal	Clinical Physiology and Functional Imaging
Volume	42
Issue	1
Pages (from-to)	15-22
Number of pages	8
ISSN	1475-0961
DOIs	https://doi.org/10.1111/cpf.12730
Publication status	Published - Jan 2022

Keywords

angiography
atherosclerosis
clinical laboratory techniques
diagnosis
intestinal angina
DIAGNOSIS
CHRONIC INTESTINAL ISCHEMIA
TONOMETRY
SPLANCHNIC BLOOD-FLOW
Aniline Compounds
Humans
Glycine
Mesenteric Ischemia/diagnostic imaging
Mesenteric Arteries
Oxygen Saturation
Chronic Disease

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title = "Chronic mesenteric ischaemia:: the importance of the individual mesenteric artery",

abstract = "Background: Chronic mesenteric ischaemia (CMI) is a vastly underdiagnosed condition that typically leads to postprandial abdominal pain and weight loss. The aim of the study was to explore the involvement of various mesenteric vessels in total splanchnic blood flow (SBF) and hepatic vein oxygenation. Methods: Single-blinded comparative trial of 476 patients clinically suspected of CMI. Routine investigation included measurement of hepatic vein oxygen saturation, indirect measurement of the total splanchnic blood flow (SBF), using Fick's principle and the tracer [ 99mTc]Mebrofenin, before and after a meal, and digital subtraction angiography. Results: A total of 176 of the 476 patients (36%) had at least one angiographically significant stenosis (lumen reduction ≥70%). In patients with a significant one-vessel disease, the percentage having CMI according to SBF was 10% for a celiac trunk stenosis (n = 60), 50% for a superior mesenteric stenosis (n = 24) and 6% for an inferior mesenteric artery stenosis (n = 34). In patients with a significant two-vessel disease, the percentage with CMI according to SBF response was 92%, 18% and 79%, for no significant stenosis of the celiac trunk (n = 13), superior mesenteric artery (n = 17) and inferior mesenteric artery (n = 19), respectively. Conclusion: Patients with significant one- or two-vessel stenosis involving the superior mesenteric artery have a higher likelihood of CMI according to flow criteria and a greater postprandial decrease in hepatic vein saturation on average than patients with no involvement of the superior mesenteric artery. ",

keywords = "angiography, atherosclerosis, clinical laboratory techniques, diagnosis, intestinal angina, DIAGNOSIS, CHRONIC INTESTINAL ISCHEMIA, TONOMETRY, SPLANCHNIC BLOOD-FLOW, Aniline Compounds, Humans, Glycine, Mesenteric Ischemia/diagnostic imaging, Mesenteric Arteries, Oxygen Saturation, Chronic Disease",

author = "Christian H{\o}yer and Christensen, {Mette H{\o}gh} and Jes Sandermann and Leusink, {Robert Johannes} and Jan Abrahamsen",

year = "2022",

month = jan,

doi = "10.1111/cpf.12730",

language = "English",

volume = "42",

pages = "15--22",

journal = "Clinical Physiology and Functional Imaging",

issn = "1475-0961",

publisher = "Wiley-Blackwell Publishing Ltd",

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}

Chronic mesenteric ischaemia: the importance of the individual mesenteric artery. / Høyer, Christian; Christensen, Mette Høgh; Sandermann, Jes et al.
In: Clinical Physiology and Functional Imaging, Vol. 42, No. 1, 01.2022, p. 15-22.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Chronic mesenteric ischaemia:

T2 - the importance of the individual mesenteric artery

AU - Høyer, Christian

AU - Christensen, Mette Høgh

AU - Sandermann, Jes

AU - Leusink, Robert Johannes

AU - Abrahamsen, Jan

PY - 2022/1

Y1 - 2022/1

N2 - Background: Chronic mesenteric ischaemia (CMI) is a vastly underdiagnosed condition that typically leads to postprandial abdominal pain and weight loss. The aim of the study was to explore the involvement of various mesenteric vessels in total splanchnic blood flow (SBF) and hepatic vein oxygenation. Methods: Single-blinded comparative trial of 476 patients clinically suspected of CMI. Routine investigation included measurement of hepatic vein oxygen saturation, indirect measurement of the total splanchnic blood flow (SBF), using Fick's principle and the tracer [ 99mTc]Mebrofenin, before and after a meal, and digital subtraction angiography. Results: A total of 176 of the 476 patients (36%) had at least one angiographically significant stenosis (lumen reduction ≥70%). In patients with a significant one-vessel disease, the percentage having CMI according to SBF was 10% for a celiac trunk stenosis (n = 60), 50% for a superior mesenteric stenosis (n = 24) and 6% for an inferior mesenteric artery stenosis (n = 34). In patients with a significant two-vessel disease, the percentage with CMI according to SBF response was 92%, 18% and 79%, for no significant stenosis of the celiac trunk (n = 13), superior mesenteric artery (n = 17) and inferior mesenteric artery (n = 19), respectively. Conclusion: Patients with significant one- or two-vessel stenosis involving the superior mesenteric artery have a higher likelihood of CMI according to flow criteria and a greater postprandial decrease in hepatic vein saturation on average than patients with no involvement of the superior mesenteric artery.

AB - Background: Chronic mesenteric ischaemia (CMI) is a vastly underdiagnosed condition that typically leads to postprandial abdominal pain and weight loss. The aim of the study was to explore the involvement of various mesenteric vessels in total splanchnic blood flow (SBF) and hepatic vein oxygenation. Methods: Single-blinded comparative trial of 476 patients clinically suspected of CMI. Routine investigation included measurement of hepatic vein oxygen saturation, indirect measurement of the total splanchnic blood flow (SBF), using Fick's principle and the tracer [ 99mTc]Mebrofenin, before and after a meal, and digital subtraction angiography. Results: A total of 176 of the 476 patients (36%) had at least one angiographically significant stenosis (lumen reduction ≥70%). In patients with a significant one-vessel disease, the percentage having CMI according to SBF was 10% for a celiac trunk stenosis (n = 60), 50% for a superior mesenteric stenosis (n = 24) and 6% for an inferior mesenteric artery stenosis (n = 34). In patients with a significant two-vessel disease, the percentage with CMI according to SBF response was 92%, 18% and 79%, for no significant stenosis of the celiac trunk (n = 13), superior mesenteric artery (n = 17) and inferior mesenteric artery (n = 19), respectively. Conclusion: Patients with significant one- or two-vessel stenosis involving the superior mesenteric artery have a higher likelihood of CMI according to flow criteria and a greater postprandial decrease in hepatic vein saturation on average than patients with no involvement of the superior mesenteric artery.

KW - angiography

KW - atherosclerosis

KW - clinical laboratory techniques

KW - diagnosis

KW - intestinal angina

KW - DIAGNOSIS

KW - CHRONIC INTESTINAL ISCHEMIA

KW - TONOMETRY

KW - SPLANCHNIC BLOOD-FLOW

KW - Aniline Compounds

KW - Humans

KW - Glycine

KW - Mesenteric Ischemia/diagnostic imaging

KW - Mesenteric Arteries

KW - Oxygen Saturation

KW - Chronic Disease

U2 - 10.1111/cpf.12730

DO - 10.1111/cpf.12730

M3 - Journal article

C2 - 34608740

SN - 1475-0961

VL - 42

SP - 15

EP - 22

JO - Clinical Physiology and Functional Imaging

JF - Clinical Physiology and Functional Imaging

IS - 1