Can ostial celiac artery or SMA occlusion result in mesenteric ischemia?
Because of the extensive collaterals between the three main mesenteric vessels, occlusion of just one of these three vessels usually does not cause symptoms or signs of mesenteric ischemia. Severe stenosis of at least two of the vessels is generally necessary for symptomatic mesenteric ischemia. The state of the celiac artery and SMA is important to determine during preoperative planning for stent graft repair of an AAA. The reason is that the IMA is occluded during the placement of a stent graft, and the IMA may be the sole supply of blood to the gut.
Acute mesenteric ischemia is most commonly secondary to arterial embolic disease (in 40% to 50%) followed by arterial thrombosis (in 20% to 30%), whereas chronic mesenteric ischemia is most commonly secondary to atherosclerotic disease.
