About the disease
Mesenteric artery atherosclerosis is chronic disease, in which cholesterol and other natural fats accumulate as plaques on the inner walls of arteries which results in loss of walls elasticity.
In that case walls themselves lose their elasticity. Plaques lead to narrowing of artery lumen which makes blood flow difficult. Usually people develop mesenteric artery atherosclerosis in middle and older age. However, artery atherosclerosis can in some case be detected in children and even newborns.
Mesenteric artery atherosclerosis is more widespread in men over 45 years old and who are subject to frequent stress. Hereditary factor also plays an important role. Obesity, gallstones and other nutritional problems contribute to development of mesenteric artery atherosclerosis. In fact, excess fat is the biggest predisposing factor of mesenteric artery atherosclerosis. Low physical activity, psycho-emotional voltage, traumas of nervous system, frequent exposure to loud noise, specific working conditions can also contribute to development of mesenteric artery atherosclerosis.
In healthy people, blood flows freely through vital arteries to all other parts of the body, supplying them with oxygen deposits and other vital nutrients. If blood contains excessive amount of cholesterol, fat accumulates on inner surface of blood vessels. It also starts to form plaques. Mesenteric atherosclerotic plaque is a malformation consisting of a mixture of fat (which is primarily cholesterol) and calcium. Over time, plaque becomes unstable and defects arise on its surface. Blood clot begins to develop inside blood vessel mainly because of platelets (blood elements involved in the clotting process) and blood proteins.
Thrombus narrows not only lumen of artery, but it also narrows bloodstream flowing through the vessel, so the diameter becomes so small that the blood clot gets stuck. As a result, blood supply to other organs or tissue areas stops. This leads to development of necrosis, which can result in infarction. Depending on location of thrombosis a person may develop myocardial kidney, spleen, intestinal disease and other illnesses. When there is a thrombus in blood vessels that feeds heart, a person develops myocardial infarction, which is the most dangerous complication of artery atherosclerosis. Mesenteric artery atherosclerosis can also affect brain artery, and then the risk of stroke increases by several times.
Symptoms
- Dizziness
- Nausea
- Narrowing of arteries, mainly carotid ones
- Coronary diseases
- Certain neurological deficits
- In some cases mild or moderate muscles disability
- Development of long-term chronic diseases
- Stress
- Diabetes
Diagnosis
- Mesenteric artery atherosclerosis can develop for a long time without any significant manifestations, but modern methods of examination allow identification of this disease in its early stages. Doppler ultrasound of the arteries can diagnose mesenteric artery atherosclerosis even before a person had any symptoms. Doppler ultrasound allows a doctor estimate the size of plaque and blood flow disturbance in the narrowing of the vessel during mesenteric artery atherosclerosis.
- To evaluate the state of coronary blood vessels some doctors use coronary angiography, which is an X-rays that determines exact location of mesenteric artery atherosclerosis and degree of narrowing of artery lumen.
Treatment
- Percutaneous transluminal angioplasty and thromboendarterectomy is used to open the blood vessel outside the coronary artery. It also removes clotted blood from pulmonary artery. This surgery can be combined with installation of stent, which is a metal tab holding vessel lumen in its expanded state. Sometimes doctors replace the damaged blood vessel to create new path for blood flow.
- A doctor can also perform laparoscopic decompression of the celiac trunk. The surgery is minimally invasive and it is done by individual punctures. This artery is then straightened, eventually restoring its normal diameter. Previously, these operations were carried out on open abdomen. Even though they were effective, laparoscopic decompression on stomach was usually accompanied by severe postoperative period, which is characteristic of any open surgery. That`s why now doctors usually conduct laparoscopic decompression on the diaphragm to achieve a good cosmetic result and have less postoperative complications.
- Shunt surgery, which is narrowing and occlusion of the celiac trunk is used in advanced stages of atherosclerosis, when the stent is set to remove atherosclerotic plaque from the vessel. The aim of this surgery is to form bypass blood flow in addition to the affected celiac trunk or to replace it by artificial prosthesis. These interventions are technically complicated and are performed only on the open abdomen. Shunt surgery also needs to be performed by highly skilled vascular surgeon, which would be able to operate on open abdomen.
Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko
