Mesenteric & Renal Vascular Disease involve blockage of the arteries that supply the kidneys or small intestine.
Mesenteric (intestinal) and Renal (kidney) artery disease are conditions that develop when the arteries in the abdomen that supply either the kidneys or the intestines become narrowed, or blocked, by an accumulation of a fatty substance called plaque.
As plaque builds up inside the artery walls, the arteries can become hardened and narrowed (a process called atherosclerosis). People with mesenteric or renal artery narrowing often have other cardiovascular conditions such as carotid artery disease and heart disease.
Who is at Risk?
Risk factors for mesenteric and renal artery disease include smoking, a family history of atherosclerosis, high blood pressure, diabetes, high cholesterol, advanced age, obesity, and a sedentary lifestyle. Renal artery disease can also develop as a result of fibromuscular dysplasia (FMD). FMD is a condition in which abnormal cells cause narrowing throughout certain arteries, particularly those that supply the kidneys with blood. FMD can also affect the carotid arteries and arteries in the pelvis. This condition can affect anyone but is often seen in women between the ages of 20 and 40.
With mesenteric artery disease, patients can experience weight loss and severe abdominal pain when they eat. With renal artery disease, patients can develop high blood pressure that is very difficult to control, and in extreme cases kidney failure.
Tests and Treatments
Doctors use one or more of the following imaging tests to determine the location and the extent of the arterial stenosis (narrowing of the arteries):
Minimally Invasive Procedures
Patients whose symptoms are mild to moderate can often manage their disease by making lifestyle changes such as quitting smoking, getting regular exercise, and working with their doctors to take care of related conditions such as diabetes, high blood pressure, and high cholesterol. Doctors often use minimally invasive procedures such as balloon angioplasty and stenting to relieve the narrowing and improve blood supply to the kidney and intestines.
Angiogram: An angiogram is a diagnostic imaging test that allows doctors to view blood vessels throughout the body and diagnose blockages, enlargements, clots, and malformations. An angiogram to study the arteries is called an arteriogram; one to study the veins is called a venogram. To perform these tests, doctors place a tiny, soft plastic tube called a catheter into the artery or vein, usually in the groin, and inject a dye that makes the blood vessels clearly visible on an x-ray image.
Balloon angioplasty: During angioplasty, vascular specialists use a
special catheter that has a small balloon at the end, which can be inflated and deflated. The deflated balloon catheter is inserted through an artery in the groin and guided to the narrowed segment of the artery. When the catheter reaches the blockage, the balloon is inflated to widen the narrowed artery.
Stenting: In some cases, it may be necessary to place a stent. A stent is a small tube that holds open the artery at the site of the blockage. The stent is collapsed around a balloon when it is placed on the tip of the catheter and inserted into the body. Once the catheter reaches the blockage, the doctor expands the stent by inflating the balloon. The
stent is left permanently in the artery to provide a reinforced channel through which blood can flow. Some stents (drug-eluting stents) are coated with medication that helps prevent the formation of scar tissue.
If renal or mesenteric artery disease is very advanced, or if blockages develop in an artery that is difficult to reach with a catheter, arterial bypass surgery may be necessary to restore blood flow.
Arterial Bypass Surgery: To surgically correct the decreased blood flow through the artery, doctors place a bypass graft made of synthetic material or a natural vein taken from another part of the body. During the procedure, the surgeon will make an incision to expose the diseased segment of the artery, and then attach one end of a bypass graft to a point above the blockage and the other end to a point below it. The blood supply is then diverted through the graft, around the blockage, to bypass the diseased section of the artery. The diseased artery is left in place.