This paper is only available as a PDF. To read, Please Download here.
Complete revascularization for chronic intestinalischemia is controversial. Fifty-eight
patients (119 arteries) underwent mesenteric revascularization between 1981 and 1988.
There were 46 women and 12 men (mean age: 63 years). Sixty percent of patients had
three-vessel disease. Twenty-one patients underwent concomitant aortic reconstruction.
Operative mortality was 10%. Four of the six deaths occurred in patients undergoing
aortic surgery. Late graft failure occurred in five patients (10%). Five-year survival
for patients with three-vessel involvement who underwent three-vessel repair was 73%,
compared with 57% for two-vessel repair and 0% for one-vessel repair (p=NS). Similarly,
graft patency in patients with three-vessel disease was highest in those patients
who had complete revascularization (90%, 54%, and 0%, respectively) (p=NS). We conclude
that increased graft patency and survival in patients with three-vessel disease was
most frequent with complete revascularization. Diseased inferior mesenteric arteries
should be repaired if feasible. Concomitant aortic operations should be avoided if
possible.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Surgical management of chronic intestinal ischemia: a reappraisal.Surgery. 1981; 90: 940-946
- Nonparametric estimation from incomplete observations.J Am Stat Assoc. 1958; 53: 457-481
- Asymptomatically efficient rank and invariant procedures (with discussion).J Roy Stat Soc, Series A. 1972; 135: 185-207
- Atherosclerosis in the mesenteric circulation. Observations and correlations with aortic and coronary atherosclerosis.Am Heart J. 1963; 66: 200-209
- The pattern of arteriosclerotic narrowing of the celiac and superior mesenteric arteries.Ann Surg. 1959; 149: 684-689
- Celiac axis, superior mesenteric artery, and inferior mesenteric artery occlusion: surgical considerations.Surgery. 1977; 82: 856-866
- Durability of endarterectomy and antegrade grafts in the treatment of chronic visceral ischemia.J Vasc Surg. 1986; 3: 799-806
- Surgical treatment of abdominal angina: review of 25 patients.Surgery. 1974; 75: 682-689
- Chronic intestinal ischemia.Surg Gynecol Obstet. 1977; 145: 321-328
- Chronic mesenteric arterial insufficiency: results of revascularization in 33 cases.South Med J. 1976; 69: 1266-1268
- Treatment of chronic visceral ischemia.Am J Surg. 1984; 148: 138-144
- Intestinal angina. Report of a case with preoperative diagnosis and surgical relief.N Engl J Med. 1959; 260: 912-914
- Hemodynamic basis of the pain of chronic mesenteric ischemia.Am J Surg. 1987; 153: 171-176
- Recent trends in the diagnosis and management of chronic intestinal ischemia.Ann Vasc Surg. 1990; 4: 126-132
- Abdominal pain of vascular origin.Am J Med Sci. 1936; 192: 109-113
- Percutaneous transluminal angioplasty in the treatment of abdominal angina.AJR Am J Roentgenol. 1986; 139: 247-249
- Chronic intestinal ischemia: diagnosis and therapy.J Vasc Surg. 1986; 4: 338-344
- Revascularization methods in chronic visceral ischemia caused by atherosclerosis.Ann Surg. 1977; 186: 468-476
- Progress in chronic mesenteric arterial ischemia.J Cardiovasc Surg. 1989; 30: 178-184
- Surgical treatment of chronic mesenteric arterial insufficiency.J Vasc Surg. 1988; 8: 495-500
Article info
Footnotes
**Presented at the 20th Annual Meeting of the Society for ClinicalVascular Surgery, Orlando, Florida, March 25–29, 1992.
Identification
Copyright
© 1992 Reed Publishing USA. Published by Elsevier Inc.