Mesenteric Artery Ultrasound and Prevention
Ultrasound of the superior mesenteric artery is used to diagnose stenosis, thrombosis, and emboli. In a stable patient, this can be used in conjunction with confirmation via CT imaging to plan a protocol of close surveillance and/or conservative endovascular management to prevent embolization and bowel ischemia.
Chronic disease in stable patients can allow prevention of bowel ischemia or necrosis via all of the therapeutic tools used in preventing complications from any atherosclerotic disease process:
- Control of hypertension with antihypertensive medications(s)
- Management of dyslipidemia (high cholesterol/triglyceride) with statin drugs
- Strict glycemic control in diabetics, including maintenance of a target glycated hemoglobin A1c
- Smoking cessation
- Diet and nutrition consultation
- Physical exercise
- Weight management
- Specific to mesenteric artery atherosclerosis, prevention of ischemic sequelae includes
- Close surveillance via mesenteric artery ultrasound and confirmatory CT imaging
- Revascularization via endovascular balloon angioplasty or mechanical thrombectomy
- Pre-emptive elimination of thrombus via mesenteric artery by-pass surgery
- In acute situations, prevention of sepsis and death is realized via emergency surgery and bowel resection
Mesenteric artery stenosis is a serious risk to organs that do not have a generous, forgiving collateral circulation, and patients with such a diagnosis benefit from strategies to prevent serious, life-threatening consequences.