Durability of antegrade synthetic aortomesenteric bypass for chronic mesenteric ischemia

Abstract

Antegrade synthetic aortomesenteric bypass for CMI is associated with good functional outcome and long-term graft patency.

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

“…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.…”

Acute and Chronic Mesenteric Ischemia

“…Although reversed saphenous vein grafts are more appropriate in the setting of gross contamination from infarcted bowel [46], prosthetic grafts may in fact be more durable for mesenteric artery bypass. Although no randomized trials exist regarding the use of prosthetic versus endogenous grafts, most modern series indicate a preference for the use of prosthetic grafts in this setting [3,14,22,[47][48][49][50]. Synthetic grafts also offer the benefit of facilitating simultaneous revascularization of the CA and SMA through a single aortotomy with the use of bifurcated grafts.…”

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

“…Several reports of concurrent series treated by angioplasty/stenting or surgery indicate that recurrences after percutaneous procedures have been more frequent than after open surgery, but many of the recurrences can be managed by percutaneous interventions (250). The results of several series are listed in Table 42 Surgical treatment of chronic intestinal ischemia is accomplished by endarterectomy or bypass grafting, with the majority of surgeons preferring the latter approach (239,(251)(252)(253)(254)(255)(256)(257)(258). In chronic cases, the overall operative mortality and durability of revascularization described by multiple contemporary reports are listed in Table 42 in the full-text guidelines.…”