Because of the normal collateral circulation, disease in two of the three vessels is usually necessary to produce symptoms. There is a lack of correlation between the demonstration of an anatomical defect and symptoms in patients with intestinal angina. Symptoms can be present with a single occluded vessel, or symptoms may be absent with occlusion of two of the three visceral arteries. In patients with unexplained abdominal pain and weight loss whose angiographic studies reveal occlusion or stenosis in two of the three intestinal arteries, chronic intestinal ischemia should be considered. The success of percutaneous angioplasty varies with the etiology of the stenosis.
Ostial lesions respond poorly to angioplasty.
These patients with intestinal angina are usually elderly people with significant medical problems. Transluminal angioplasty appears to be safe and reliable. It may be less hazardous thanlex and should be considered when treating these patients. The superior mesenteric artery has been dilated to normal caliber. Transluminal Treatment of Arteriosclerotic Obstruction.