Editor's Choice – Management of the Diseases of Mesenteric Arteries and Veins

Abstract

She participated very actively in the process of developing these guidelines, in particular the important chapters on chronic arterial and venous mesenteric ischaemia. Six days after the second meeting of the task force she died unexpectedly, to our great despair and loss. We honour her dedication and scientific integrity by completing these guidelines. Among many other commitments she was a very productive reviewer and an associate editor of this journal. You can read more about Paola's important contributions to science and to the vascular community in the April 2016 issue of the European Journal of Vascular and Endovascular Surgery. 1

<p>A Short Series of Laparoscopic Mesenteric Bypasses for Chronic Mesenteric Ischemia</p>

“…Mesenteric arteries were defined as celiac artery (CA), superior mesenteric artery (SMA), and inferior mesenteric artery (IMA). 6 SMA was the main artery selected for revascularization even in cases where both CA and SMA had occlusion or stenosis. The splenic artery was chosen for revascularization when the atherosclerotic occlusion was only confined to CA.…”

“…[2][3][4][5] Due to reduced perioperative morbidity, guidelines recommend endovascular therapy as the first choice for the treatment of CMI. 6,7 However, in case of failed endovascular therapy or in patients with occlusion and extensive calcification precluding safe angioplasty and stenting, a bypass from aorta to either superior mesenteric artery (SMA)/ celiac artery (CA) or both is indicated. 6 Laparoscopic mesenteric bypass operation techniques have been introduced to achieve the advantages of a minimally invasive surgical technique.…”

“…6,7 However, in case of failed endovascular therapy or in patients with occlusion and extensive calcification precluding safe angioplasty and stenting, a bypass from aorta to either superior mesenteric artery (SMA)/ celiac artery (CA) or both is indicated. 6 Laparoscopic mesenteric bypass operation techniques have been introduced to achieve the advantages of a minimally invasive surgical technique. 8,9 However, no study has yet been performed to investigate the feasibility of the laparoscopic mesenteric bypass operation technique.…”

Oxygen‐dependent delayed fluorescence of protoporphyrin IX measured in the stomach and duodenum during upper gastrointestinal endoscopy

“…PO 2 measurements in cells of the GI tract during endoscopy could be of great value, for example, for the diagnostic work‐up of patients suspected to be suffering from chronic mesenteric ischemia (CMI). CMI is the result of insufficient blood supply to the GI tract caused by obstruction of mesenteric arteries and/or veins . CMI is in >90% caused by atherosclerosis of minimally one mesenteric artery.…”

“…CMI is in >90% caused by atherosclerosis of minimally one mesenteric artery. Typical symptoms of CMI are postprandial abdominal pain and weight loss, however, more atypical symptoms as nausea, constant abdominal discomfort, vomiting, diarrhea or constipation are also reported . Symptoms alone are of limited value for the diagnosis of CMI .…”