The visceral arteries supply blood to the intestines, spleen, and liver. Visceral artery conditions are acute or chronic conditions that reduce blood flow in these arteries.
As with other blood vessels, the visceral arteries can either become blocked (usually by plaque) or dilated (by aneurysms).
Frequently, a buildup of atherosclerotic plaque causes visceral artery ischemic (lack of blood supply) conditions.
Surgical and minimally invasive procedures that restore blood flow can treat these conditions.
Visceral artery conditions affect the major arteries that supply the intestines, spleen, and liver. In visceral artery conditions, blood flow through these arteries becomes reduced or blocked. Most often, the narrowing or blockage is caused by the accumulation of fatty plaque from atherosclerosis, or hardening of the arteries, a condition called occlusive disease.
Atherosclerosis in the visceral arteries can cause ischemia, or lack of oxygen in body tissues that causes pain; eventually, the affected organs may not function properly or may even fail.
More rarely, visceral artery conditions involve aneurysms, which are balloon-like weak areas in the arteries that can cause life-threatening hemorrhage (bleeding).
WHAT ARE THE SYMPTOMS?
If a blood clot suddenly blocks a narrowed artery supplying the abdominal organs, especially the intestines, the primary symptom is severe and widespread abdominal pain. Such blockage can be lethal, and immediate diagnosis and treatment are essential.
Additional symptoms of acute arterial blockage to the intestines are:
Having to evacuate the bowels, which can quickly become bloody;
An abnormal drop in blood pressure;
The rapid accumulation of white blood cells in the blood; and
Acidosis, the buildup of hydrogen in the blood.
Gradual narrowing of an affected artery or arteries can cause pain in the abdomen after meals. Eventually, substantial weight loss can result.
Severe, sudden abdominal or back pain may indicate imminent rupture of an aneurysm in the visceral arteries. Patients whose aneurysm has ruptured may collapse and go into shock.
CAUSES AND RISK FACTORS
Atherosclerosis appears to be the main cause of visceral artery occlusive disease and aneurysms.
Risk factors for atherosclerosis include:
High blood pressure;
Having a family history of cardiovascular disease.
The chances of developing visceral artery occlusion increase after age 50.
An invasive x ray technique called arteriography is the most important test for identifying visceral artery conditions. Other methods that may be used in addition to arteriography include:
Computed tomography (CT) scans; and
Magnetic resonance angiography (MRA).
When a patient has acute blockage in an intestinal artery, the surgeon may remove the plaque surgically (called endarterectomy) or reroute blood flow in the artery using a bypass graft. In some cases, drugs can dissolve a blood clot during an intervention called thrombolysis.
Physicians may use endarterectomy, surgical bypass, or angioplasty and stenting to treat chronic narrowing or occlusion of a visceral artery.
In cases of a ruptured aneurysm, which is a medical emergency, the aneurysm is removed surgically and the artery is repaired with a graft.
Aneurysms that have not burst are either monitored carefully for increases in size, or they are operated on if they are large. Physicians usually perform surgery to treat aneurysms, although minimally invasive treatments, such as endovascular stent graft or embolization, may be used in high-risk patients.
Most visceral artery conditions result from atherosclerosis, a progressive disease that is complicated by poor lifestyle choices. Lifestyle changes that may slow the progress of atherosclerosis include: