Intestinal ischemic syndromes -- also called visceral or mesenteric ischemic syndromes -- occur when blood flow to the bowel or gastrointestinal system (intestines) is decreased because of a blood vessel blockage. Treatment is needed to prevent permanent damage to the tissues.
Thrombolytic therapy uses drugs designed to dissolve clots and restore normal blood flow. Your physician will inject a clot-dissolving medication into a blood vessel. A catheter (a long, thin tube) may also be used to deliver the medication or to break up the clot. This is not a common treatment for this disease.
Angioplasty is used to widen the artery that is narrowed.. During angioplasty, a small balloon at the tip of the catheter is inflated to stretch the artery open and increase blood flow. A stent may be necessary at times and is placed during the angioplasty procedure to keep the artery open. A stent is a small, metal mesh tube that acts as a scaffold and provides support inside the artery. A balloon catheter, placed over a guide wire, is used to insert the stent into the narrowed vein. Once in place, the balloon is inflated and the stent expanded to the size of the artery holding it open. The balloon is deflated and removed, and the stent stays in place permanently.
When is surgery for visceral ischemic syndrome necessary?
Emergency visceral ischemic syndrome surgical treatment may be performed to remove the blood clot or bypass the blocked vessel and restore blood flow to the intestines. This is particularly true of acute mesenteric ischemia. If tissue death has occurred, the surgeon may need to remove a portion of the intestine if tissue death has occurred.
Otherwise, surgery is indicated when the blockage has drastically reduced the blood flow to the intestines.
Visceral ischemic syndrome surgical treatment may be performed to remove plaque (atherectomy/endarterectomy), bypass the blocked vessel to restore blood flow to the intestines, or remove or repair an aneurysm.
A surgical intestinal bypass reroutes blood flow around the blood vessel blockage by creating a new pathway for blood flow using a graft. To bypass the blockage, the surgeon makes a small opening just below the blockage in the diseased artery and places a graft, which is either a portion of one of your veins or a man-made synthetic tube. The surgeon will connect the graft above and below a blockage to allow blood around the blockage.
Intestinal endarterectomy may be performed to surgically remove the blockage. The surgeon will make an incision in the affected artery and remove the plaque contained in the artery's inner lining restore blood flow.
Outcomes for visceral ischemic syndrome surgical treatment at Cleveland Clinic
Surgery for chronic mesenteric ischemia is successful at relieving the pain associated with the disease in more than 90 percent of patients. Unfortunately, nearly 10 percent of patients develop a recurrence of symptoms at some point in their life. The recurrence is typically due to progression of the atherosclerotic disease. This can be prevented by adopting a healthy lifestyle.