Chronic Mesenteric Vascular Syndrome

Abstract

Since 1961, 14 patients at the University Hospital of Leiden, the Netherlands, have undergone reconstructive surgery for treatment of chronic mesenteric vascular syndrome. Of the 42 mesenteric arteries, 31 were severely obstructed (mean, 2.2 stenotic arteries per patient). A total of 23 mesenteric arteries were repaired. Long-term follow-up data were available for all 13 surviving patients (mean follow-up, 11.8 years). Symptoms were relieved immediately after surgery, and relief was maintained during follow-up. Digital subtraction angiography at long-term follow-up evaluation was performed in eight patients (13 reconstructions) with these results: 11 (85%) of the 13 reconstructions were patent and severe stenoses were found in eight (33%) of the 24 mesenteric arteries (mean, 1.0 stenotic artery per patient). We conclude that reconstructive surgery for patients with chronic mesenteric vascular syndrome promptly relieves symptoms, provides excellent patency, and has long-lasting beneficial results.

Patients with chronic mesenteric ischemia have an altered sublingual microcirculation

“…This is however only present in 16%–21% of patients and has limited predictive value for diagnosing CGI. 22 , 26 , 27 This supports the current diagnostic approach that combines assessment of clinical symptoms with radiological imaging of the gastrointestinal arteries and functional testing by tonometry or VLS. 2 This is not the ideal gold standard; however, it is currently the most reliable way to establish CMI.…”

Chronic mesenteric ischemia : with a focus on collateral circulation

“…40,41 However, in 1960, Stewart described an earlier successfully performed embolectomy in 1951, with survival of the patient. 42 It must be remembered that it was not until 1963 that Fogarty described his new technique for embolectomy, after which he published his results in 1971. 43,44 Until the availability of the Fogarty catheter, Part 1 | Chapter 1 embolectomy had to be performed by gentle pressure or suction.…”

“…Almost all studies, including those with multiple-vessel CSS patients treated with OR, supported the statement that long-term relief of symptoms can be achieved best by repair of more Part 3 | Chapter 9 than one splanchnic artery. 28,38,[40][41][42] The results of the uncontrolled ER series are summarized in Table II. In the ER series, the concept of preferable multiple-vessel revascularization was both supported 22,39,46 and rejected, 29,58 albeit with a high risk of confounding.…”