Renal & Mesenteric Disease

As with other blood vessels, those feeding the intestines (mesenteric) and kidneys (renal) can become blocked. When this happens, the organs may not function correctly or may even fail. The vessel can be unblocked by angioplasty or endarterectomy.

What to expect

Before any of these procedures:

Avoid aspirin and other medications that thin your blood.
Talk with your physician about any prescription drugs, over-the-counter drugs or supplements you may be taking.
Unless your physician says something different, do not have anything to eat or drink after midnight. You may take morning medications with sips of water if your doctor says it is okay.

Angioplasty can be done either as an outpatient procedure or with an overnight hospital stay. There is no need for general anesthesia. Recovery time is short.

During the procedure:

A small incision is made.
A catheter is threaded through the artery.
When it gets there, a small balloon is blown up to press the obstruction out of the way.
Depending on your particular case, the surgeon may then place a tiny, wire mesh tube called a stent to help keep the vessel open.

Endarterectomy

During the procedure:

The surgeon will make a small incision near the area of concern.
The blood vessel will be cut open and the inner lining, as well as any plaque deposits, will be removed.

After the procedure:

Most patients will go to the recovery room for a few hours until waking up.
If your vital signs are stable, you will be moved to the vascular care unit overnight. Barring complications, you should be discharged the day after the procedure.

If other, less invasive treatments don't work, your doctor may surgically bypass the obstruction. As with heart bypasses, this involves the doctor taking a healthy segment from another vein or artery.

Bypass

During the procedure:

The doctor cuts the vessel on both sides of the obstruction.
The healthy tissue is then sewed to the ends, which lets the blood flow around (bypass) the blocked area.

After the procedure:

You will go to the recovery room until you are awake and your vital signs are stable.
Next, you'll go to an Intensive Care Unit for a day or two.
The normal hospital stay is around a week.
As soon as possible, you will be encouraged to get up and walk around. This helps with blood flow and can prevent clots from forming. It also prevents pneumonia.

The kinds and length of activity restrictions will depend on the kind of treatment. For angioplasty, you should be able to do everything except exercise and lifting within a few days. If you have a bypass, it may be a month or more before you are back to your normal activity level. Make sure you understand your physician's instructions.