From what was reported, angioplasty alone did have some benefit, but there was a real need for improvement in immediate- and longer-term results. In an effort to improve these, Ivancev’s group described the first sma stent, which included not only stenting the sma but also recanalizing a chronic total occlusion (CTO) [15]. They reported continued patency 9 months after the intervention, which was documented by angiography. Since the time of early reports, balloon angioplasty and stenting of mesenteric occlusive disease were slow to be adopted. However, with refinement in techniques, lower-profile devices, and extended training of multiple subspecialties, soon many case series described the success of PTA and stenting of the visceral vessels [16] (Table 14.2). Sheeran et al. looked at their results of PTA and stent in 12 patients, 3 of whom were chronic total occlusions. Their initial technical success was 92 %, including 3 patients with chronic occlusions. One patient died within 30 days of the procedure (mortality 8.3 %) due to bowel infarction, despite a patent stent. Primary and primary-assisted patency was 74 % and 83 % respectively, and secondary patency was 83 %. All three patients with chronic occlusions had relief of clinical signs and symptoms at a mean follow-up of 22 months. Chahid et al. reported their results after treating 14 patients [17]. Their technical success and initial clinical success was 100 %. Long-term relief of symptoms was 79 %, and two patients underwent repeat angioplasty for an absolute patency rate 86. Two major complications were observed: one hematoma and one false aneurysm occurring at the brachial puncture site (14.3 %).

Matsumoto reported one of the first larger series of patients [18]. He reviewed their experience of PTA and stenting in a group of 33 patients. Twenty-one patients underwent PTA alone and 12 PTA and stenting. Technical success occurred in 81 % of patients with PTA and 100 % PTA and stent. The long-term clinical success was 83.3 %, and assisted clinical success was 96.6 % as four patients underwent repeat angioplasty. Patency rates were not reported. The complication rate was 13 % and 30 day mortality 0 %. Another large series was published by Sharrudin et al. [19] They evaluated their results of mesenteric stenting in 25 patients, 21 of whom were done for chronic mesenteric ischemia. Their reported technical success was 96 %, and clinical outcomes showed primary and primary-assisted clinical benefits at 11 months of 85 % and 91 %. He also was the first to report actuarial Kaplan Meier patencies, which were both 92 % at six months. Major complications occurred in three patients for a rate of 12 %.