Mesenteric arterial disease
Patent referred for surveillance of aortic endovascular graft.
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The celiac axis origin appear significantly narrowed on b-mode imaging. Peak systolic velocities are significantly elevated suggesting a high-grade >70% stenosis.
The superior mesenteric artery origin appears narrowed and has an acute take-off. There appears to be post-stenotic dilatation. Peak systolic velocities within the stenotic segment are significantly elevated suggesting a >70% stenosis.
This patient had endovascular repair of an abdominal aortic aneurysm. Aliasing of the celiac axis and proximal superior mesenteric artery was noted on colout Doppler assessment of the graft. B-mode imaging indicated significant stenoses of these vessels graded at >70% by spectral Doppler analysis.
The patient was asymptomatic for mesenteric ischemia. However he is at risk as both the celiac axis and superior mesenteric artery are stenosed.
Post-prandial scanning to assess for the level of velocity increase after food ingestion was not performed due to time constraints and lack of symptoms.