Based on the patient’s symptoms of chronic postprandial abdo | Figure 1

Case Report

Based on the patient’s symptoms of chronic postprandial abdominal pain and mesenteric arterial disease on CTA imaging, chronic mesenteric ischemia (CMI) was suspected. Catheter angiography demonstrated approximately 6 cm occlusion of the proximal SMA with distal reconstitution from collaterals. Severe stenosis of the IMA at the origin was also demonstrated. Two 4mm x 38 mm Xience stents were placed into the SMA in an overlapping fashion. It is important to note that at least 2 of the 3 visceral vessels need to be affected before patient develops symptoms due to chronic mesenteric ischemia.

Quiz

Which of the following statements is TRUE?

a. The superior mesenteric artery (SMA) may be sacrificed without causing bowel ischemia.
b. Ligation of the inferior mesenteric artery (IMA) will cause ischemia to the large bowel but not the small bowel.
c. The IMA may be sacrificed without colonic ischemia because of collateral circulation via the marginal artery and hemorrhoidal arteries.
d. The IMA may be sacrificed without chronic ischemia because of collateral circulation via the ileocolic artery.
e. Neither the superior nor the inferior mesenteric arteries may be sacrificed without causing bowel ischemia.

Images

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