Open and Endovascular Revascularization of the Mesenteric or Renal Arteries
Atherosclerosis can affect any part of the body. The renal and mesenteric arteries are extremely close to each other within the aorta. The endovascular process for treatment of these vessels is similar. However, the indications are quite different. Renal artery atherosclerosis is often asymptomatic except for high blood pressure that is difficult to control even with multiple medications. If imaging suggests the presence of renal artery stenosisangiography can confirm the stenosis the vascular surgeon can proceed with stenting of the indicated area. Symptomatic chronic mesenteric stenosis on the other hand is characterized by weight loss and pain after eating. Some patients have so much pain they become afraid to eat and continue to lose weight. Imaging is suggestive and angiography is diagnostic of the disease. Usually, stent placement resolves the patient’s postprandial pain. Most patients are discharged home the day after the procedure and resume normal activities.
Prior to advances in endovascular technology, a vascular surgeon’s only option was an open bypass. These bypasses were intense procedures that required a patient to have optimum health to tolerate the procedure. The ultimate goal, as with a stent, is to restore blood flow to decrease or resolve symptoms. Similar to other bypass procedures the steps are the same: obtain proximal and distal control of each of the bypass points and sew the conduit in place. However, during this procedure, unlike a lower extremity bypass, the surgeon has to prevent damage to intestines, ureters, and other abdominal organs during the dissection. This procedure has serious risks, such as heart attack, serious bleeding, andinjury to the bowel and other organs. It is important that patients are aware of these risks prior to the procedure and find a qualified surgeon to minimize potential complication.
Ultimately, a number of criteria are in play when determining the potential for success of this procedure. These factors include the capabilities of the facility hosting the procedure, the experience of the surgeon, and the comorbidities of the patient undergoing the procedure. Dr. Jenna Kazil is a fine vascular surgeon in Manatee County, FL who performs revascularization procedures at the Florida Surgical Clinic. Dr. Kazil has an impressive track record of successful procedures. Patients in need of the finest Manatee County vascular surgeon should visit the Florida Surgical Clinic for all their vascular and surgical needs.
