Risk Factors and Outcomes following Revascularization for Chronic Mesenteric Ischemia

Kihara, Todd K.; Blebea, John; Anderson, Karla M.; Friedman, Diane; Atnip, Robert G.

doi:10.1007/s100169900218

Cited by 62 publications

(38 citation statements)

References 20 publications

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“…[1][2][3][4][5][6][7][8][9][10][11] Our practice has evolved from complete retrograde revascularization and a low threshold for concomitant aortic reconstruction to a preferential use of antegrade reconstructions based on the supraceliac aorta, reserving aortic reconstruction for the rare patient who needs it for an inflow source or in whom aortic pathology necessitates repair. 1 We have found the iliac artery to be good source of inflow in high-risk patients or those with diseased or calcified aortas.…”

Section: Discussionmentioning

confidence: 99%

“…Open revascularization (OR) has been the timehonored treatment and provides immediate relief of symptoms in most patients. [1][2][3][4][5][6][7][8][9][10] Sustained symptom improvement is noted in 78% to 100% of patients, and 3-year patency rates are 76% to 100%. [1][2][3][4][5][6][7][8][9][10] Potential disadvantages are the mortality (4% to 15%) and morbidity (20% to 30%) associated with OR.…”

mentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10] Sustained symptom improvement is noted in 78% to 100% of patients, and 3-year patency rates are 76% to 100%. [1][2][3][4][5][6][7][8][9][10] Potential disadvantages are the mortality (4% to 15%) and morbidity (20% to 30%) associated with OR. [1][2][3][4][5][6][7][8][9][10] Endovascular revascularization (ER) has emerged as an alternative treatment in the elderly or higher-risk patient, but its use in low-risk operative candidates is not well defined.…”

mentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10] Potential disadvantages are the mortality (4% to 15%) and morbidity (20% to 30%) associated with OR. [1][2][3][4][5][6][7][8][9][10] Endovascular revascularization (ER) has emerged as an alternative treatment in the elderly or higher-risk patient, but its use in low-risk operative candidates is not well defined. 11 Mortality rates range from 0% to 11%, symptom relief occurs in 52% to 80% of patients, and 3-year patency rates are 40% to 88%.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Open versus endovascular revascularization for chronic mesenteric ischemia: Risk-stratified outcomes

Oderich

Bower

Sullivan

et al. 2009

Journal of Vascular Surgery

157

123

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Open versus endovascular revascularization for chronic mesenteric ischemia: Risk-stratified outcomes

Oderich

Bower

Sullivan

et al. 2009

Journal of Vascular Surgery

157

123

View full text Add to dashboard Cite

show abstract

“…Mortality rates are highest for patients with arterial thrombosis (70-87%), followed by non-occlusive mesenteric ischemia (70-80%), arterial embolism (66-71%), and venous thrombosis (44%). It is essential to act early on clinical suspicion and not to wait for the development of hard evidence (Kihara et al 1999;Wadman et al 2000).…”

Section: Prognosismentioning

confidence: 99%

Mesenteric Ischemia: Still a Deadly Puzzle for the Medical Community

Stamatakos

Stefanaki

Mastrokalos

et al. 2008

Tohoku J. Exp. Med.

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The main goal of this article is to update etiology, epidemiology, diagnosis, treatment and outcome of the various causes of mesenteric ischemia in order to elucidate its labyrinthine clinical riddle, by reviewing the current English medical literature. Mesenteric ischemia is a quite uncommon disorder, observed in the emergency department. It is a lifethreatening vascular emergency that requires early diagnosis and intervention to restore mesenteric blood flow and to prevent bowel necrosis and patient death. Consequently, it is a vital diagnosis to make because of its high mortality rate and its thorny complications. The underlying causes vary, and the prognosis depends on the specific findings during clinical examination. Vague and nonspecific clinical findings and limitations of diagnostic studies make the diagnosis a significant challenge. The prognosis of acute mesenteric ischemia of any type is grave. The complications following this medical jigsaw puzzle are also severe. Patients in whom the diagnosis is missed until infarction occurs have a mortality rate of 90%. Even with good treatment, up to 50-80% of patients die. Survivors of extensive bowel resection face lifelong disability. Despite the progress in understanding the pathogenesis of mesenteric ischemia and the development of treatment modalities, the entity remains a diagnostic challenge for clinicians. Delay in diagnosis contributes to a high mortality rate. Early diagnosis and adequate treatment can improve the clinical outcome. Even if diagnostic modalities have improved since the first successful attempts to confront effectively this clinical entity, mesenteric ischemia still remains a lethal diagnostic enigma for the medical community.Mesenteric Ischemia; thrombosis; bowel infarction; atherosclerosis; mesenteric venous thrombosis; mesenteric thromboendarterectomy.Tohoku

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Percutaneous retrograde revascularization of the superior mesenteric artery via the celiac artery for chronic mesenteric ischemia

Stephens

Cardenas

Safian

2010

Cathet Cardio Intervent

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An elderly woman developed chronic mesenteric ischemia (CMI) due to severe stenosis of the celiac artery and chronic total occlusion of the superior mesenteric artery (SMA). Stenting of the celiac artery resulted in resolution of CMI, but symptoms recurred 4 months later due to restenosis. We report successful sustained resolution of CMI after percutaneous retrograde revascularization of the SMA via the celiac artery.

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Risk Factors and Outcomes following Revascularization for Chronic Mesenteric Ischemia

Cited by 62 publications

References 20 publications

Open versus endovascular revascularization for chronic mesenteric ischemia: Risk-stratified outcomes

Open versus endovascular revascularization for chronic mesenteric ischemia: Risk-stratified outcomes

Mesenteric Ischemia: Still a Deadly Puzzle for the Medical Community

Percutaneous retrograde revascularization of the superior mesenteric artery via the celiac artery for chronic mesenteric ischemia

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