Percutaneous transluminal mesenteric angioplasty.

The endovascular treatment of chronic mesenteric ischemia remains in its infancy. This state is most certainly related to the small patient population affected by this devastating condition and the surgeon's limited desire to pursue percutaneous options for this group. Surgical trepidation is not unwarranted because in many facets mesenteric angioplasty is similar to percutaneous carotid intervention. Interventions in these vessels represent manipulation of terminal and unduplicated arterial systems. Complications compromising flow to either vascular bed can yield rapid grave outcomes. Despite this risk, early experience with mesenteric angioplasty for chronic ischemia suggests that it is a viable treatment alternative and that it can be performed with relative safety. A randomized prospective trial of mesenteric angioplasty with operative bypass grafting appears to be the next logical step.