Current results of open revascularization for chronic mesenteric ischemia: A standard for comparison

Park, Woosup M.; Cherry, Kenneth J.; Chua, Heidi K; Clark, Rita C.; Jenkins, Gregory D.; Harmsen, William S.; Noel, Audra A.; Panneton, Jean M.; Bower, Thomas C.; Hallett, John W.; Gloviczki, Péter

doi:10.1067/mva.2002.123753

Cited by 187 publications

(130 citation statements)

References 10 publications

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“…Although the expected increase in intestinal arterial flow that results from food ingestion can be detected and quantified by duplex scanning, this information has not added to the diagnostic accuracy of the test for establishing whether abdominal symptoms that are present are the result of intestinal ischemia (840). Surgical treatment of chronic intestinal ischemia is accomplished by endarterectomy or bypass grafting, with the majority of surgeons preferring the latter approach (836,(851)(852)(853)(854)(855)(856)(857)(858). The overall operative mortality and durability of revascularization in chronic cases described by multiple contemporary reports are listed in Table 42.…”

Section: Duplex Scanningmentioning

confidence: 99%

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

Hirsch

Haskal²,

Hertzer³

et al. 2006

Circulation

2,969

1,111

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Section: Duplex Scanningmentioning

confidence: 99%

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

Hirsch

Haskal²,

Hertzer³

et al. 2006

Circulation

2,969

1,111

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“…Endovascular therapy is appropriate for this subset of patients. 13 Percutaneous stent placement for the treatment of CMI can be performed with a high procedural success rate and a low complication rate. The long-term freedom from symptoms and vascular patency are comparable with surgical results.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Intervention of Superior Mesenteric Artery Stenosis in Elderly Patients

Penugonda

Gardi

Schreiber

2009

Clinical Cardiology

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This review article focuses on stent placement in mesenteric arteries in older patients with an increasingly common diagnosis of chronic mesenteric ischemia (CMI). We reviewed the articles that focused on the treatment of this gastrointestinal disorder by stenting/open surgical revascularization to avoid further ischemic episodes and bowel infarction and necrosis. The advantages of stent placement in mesenteric arteries are discussed in comparison to open surgical revascularization. In summary, the low morbidity and high technical success rate of catheter-based techniques have made this approach the first line of therapy for CMI due to superior mesenteric artery stenosis for many elderly patients especially high-risk operative candidates. BackgroundClinical manifestations of chronic mesenteric ischemia (CMI) can range from vague abdominal pain to debilitating states of intestinal angina resulting in significant weight loss and morbidity. CMI due to atherosclerotic occlusive disease was first reported in 1936 and is a relatively uncommon disorder. This entity usually occurs in patients over 60 y of age with other atherosclerotic symptoms. The rise in an aging population in the coming years could result in an increasing prevalence of chronic mesenteric ischemia. 1 Once the condition has been diagnosed, treatment is usually elective, except in rare cases of rapid progression to acute mesenteric ischemia. Medical management of CMI is mostly supportive. 2 If CMI is diagnosed, there are two therapeutic options: (1) surgical revascularization of 1 of the stenosed or occluded mesenteric arteries or (2) radiological intervention employing percutaneous transluminal angioplasty (PTA) with or without stent placement of 1 or more mesenteric arteries. The success of surgery or radiological intervention is determined by the relief of symptoms and the durability of such relief. 3 Traditional treatment consists of open surgical (OS) revascularization. Despite significant perioperative morbidity and mortality rates, OS revascularization has traditionally been the treatment of choice. The most frequent indications include pain relief, improvement of nutritional status, and prevention of intestinal infarction. Endovascular therapy seems to be a valid alternative, mainly in high-risk patients, with good immediate and medium-term results.

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“…Perioperative mortality ranges from 0-11% and increases to 50% in patients with acute-on-chronic symptoms [74]. Primary graft patency rates at five years ranges from 57% to 69%, and 5-year survival rates ranges from 63% to 77% [75,76]. Postoperative morbidity rates are increased with concomitant aortic replacement, renal disease, and complete revascularization while advanced age, cardiac disease, hypertension and additional occlusive diseases influence overall mortality [77].…”

Section: Treatmentmentioning

confidence: 99%

Intestinal Ischemia and Gangrene

Srivastava¹,

Pandey²,

Basu³

2011

Gangrene - Current Concepts and Management Options

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Current results of open revascularization for chronic mesenteric ischemia: A standard for comparison

Cited by 187 publications

References 10 publications

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

Percutaneous Intervention of Superior Mesenteric Artery Stenosis in Elderly Patients

Intestinal Ischemia and Gangrene

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