The visceral arteries supply the abdominal organs with blood and play a crucial role in digestion and nutrient supply. Various diseases can affect these arteries, which can lead to significant health problems.
The treatment of diseases of the visceral arteries depends on the type and severity of the disease. The most important treatment approaches include
Endovascular procedures:
In many cases, an angioplasty can be performed in which the narrowed artery is dilated with a balloon. A stent is often inserted to keep the vessel open. This method is minimally invasive and usually only requires a skin puncture, in the rarest cases only small incisions.
Surgical interventions:
Surgery may be necessary in the event of complete occlusion, aneurysms or if endovascular procedures are not possible. This includes bypass surgery, in which a bypass vessel is created, or resection of an aneurysm with replacement of the diseased vessel.
Thrombolysis or embolectomy:
In the case of acute occlusions caused by blood clots, thrombolysis (dissolution of the clot with medication) or embolectomy (surgical removal of the embolus) may be necessary.
Drug therapy:
For milder forms of atherosclerosis or to prevent thrombosis, medication such as blood thinners, cholesterol-lowering drugs or blood pressure medication can be used.
The most common clinical pictures include
Mesenteric artery constriction and occlusion (mesenteric ischaemia, angina abdominlis):
This condition occurs when one or more of the main arteries supplying the intestine are constricted or completely occluded. This can lead to an interruption of the blood supply and is a medical emergency in the case of acute occlusion, as it can lead to tissue destruction and life-threatening complications.
Atherosclerosis of the intestinal arteries:
Like other arteries in the body, the intestinal arteries can also be affected by atherosclerosis, leading to narrowing and reduced blood flow to the abdominal organs. Narrowing can be asymptomatic for a long time or gradually cause increasing pain after eating. However, these constrictions – asymptomatic or symptomatic – can also thrombose acutely and cause an emergency situation.
Aneurysm of the visceral arteries:
An aneurysm is a bulge or dilation of an artery that carries the risk of rupture and subsequent severe internal bleeding. These can occur in the arteries that supply the intestines, almost never cause symptoms and are therefore often difficult to diagnose before complications arise.
Compression syndromes (Dunbar syndrome, ligamentum arcuatum mediale syndrome):
The truncus coeliacus, the artery that supplies the liver, spleen and partly the stomach. If the course of the diaphragm is congenitally too close to the artery, the artery may be repeatedly pinched off, which in the long term can lead to an occlusion of the vessel that is not caused by atherosclerosis. In the rarest cases, patients then have abdominal discomfort associated with eating, but this is definitely not caused by a circulatory disorder but by irritation and hypertrophy of the nerve plexus around the truncus couliacus. Splitting of the diaphragmatic muscle and removal of the nerve plexus can be the treatment for a certain group of patients after detailed clarification.
In very rare cases, aneurysms can develop in the flow area of the superior mesenteric artery to the coeliac trunk as a result of vascular occlusion of the coueliac trunk.
The symptoms of diseases of the visceral arteries can vary depending on the severity and the vessel affected. The most common symptoms include
Abdominal pain:
Acute, sudden, severe abdominal pain can be a sign of mesenteric ischaemia. Chronic pain, especially after eating, may indicate chronic narrowing of the intestinal arteries.
Nausea and vomiting:
Common accompanying symptoms caused by reduced blood flow to the digestive tract.
Diarrhoea or blood in the stool:
These symptoms may indicate damage to the intestines caused by an inadequate blood supply.
Weight loss:
Involuntary weight loss often occurs in patients with chronic mesenteric ischaemia, as eating causes pain and thus reduces food intake.
Shock:
In severe cases, particularly in the event of occlusion of a major artery or aneurysm rupture, circulatory shock may occur, requiring immediate emergency medical intervention.
The prevention of diseases of the visceral arteries is largely based on reducing the risk factors for atherosclerosis and thrombosis:
Minimise risk factors:
Quitting smoking, maintaining a healthy diet, exercising regularly and losing weight all help to keep arteries healthy.
Control blood pressure and cholesterol:
Regular checks and treatment of high blood pressure and high cholesterol are crucial to reduce the risk of atherosclerosis.
Diabetes management:
Good control of blood glucose levels is important to prevent damage to the blood vessels.
Regular medical check-ups:
Regular check-ups and examinations are particularly important for people at increased risk (e.g. atrial fibrillation, previous cardiovascular disease).
Conventional and endovascular treatment of constricting and dilating pathologies of all visceral arteries
Surgical treatment of ligamentum atcuatum syndrome (Dunbar syndrome)
Surgical and endovascular treatment of intestinal artery aneurysms (splenic artery, renal artery, hepatic artery, intestinal arteries)
Surgical, endovascular and combined (hybrid) treatment of constrictions and occlusions of the truncus coeliacus and the superior mesenteric artery
