Elective bypass surgery for chronic mesenteric ischemic disease: report of 3 cases and review of the literature

• Published in: International angiology Vol. 30; no. 4; pp. 388 - 392
• Main Authors: BAKOYIANNIS, C, PSATHAS, E, TSEKOURAS, N, KAFEZA, M, GEORGOPOULOS, S, BASTOUNIS, E, PAPALAMBROS, E
• Format: Journal Article
• Language: English
• Published: Torino Minerva Medica 01.08.2011
• Subjects: Abdominal Pain - etiology; Aged; Angiography, Digital Subtraction; Biological and medical sciences; Blood and lymphatic vessels; Blood Vessel Prosthesis Implantation; Cardiology. Vascular system; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Elective Surgical Procedures; Female; Femoral Vein - transplantation; Humans; Ischemia - complications; Ischemia - diagnosis; Ischemia - physiopathology; Ischemia - surgery; Male; Medical sciences; Mesenteric Ischemia; Mesenteric Vascular Occlusion - complications; Mesenteric Vascular Occlusion - diagnosis; Mesenteric Vascular Occlusion - physiopathology; Mesenteric Vascular Occlusion - surgery; Middle Aged; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography, Doppler; Vascular Diseases - complications; Vascular Diseases - diagnosis; Vascular Diseases - physiopathology; Vascular Diseases - surgery; Vascular Patency; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Case study; Mesenteric artery; Pain; Ischemia; Chronic disease; Surgery; Surgical anastomosis; Cardiovascular disease; Abdomen
• ISSN: 0392-9590; 1827-1839

Chronic mesenteric ischemic disease is an unusual cause of chronic abdominal pain. We present our experience from open surgical treatment of patients with this rare disease followed by a short review of the literature. During the period 2006-2008, three patients were referred to our department with clinical and radiological findings of chronic mesenteric ischemic disease. In all patients, at least 2 out of 3 splachnic vessels (celiac artery, superior and inferior mesenteric artery) were occluded, with severe stenosis of the third. Open surgical revasculation was performed in all patients, using autologous or synthetic (Dacron) bypass grafts. Graft patency was examined with triplex ultrasound studies at 3, 6 and 12 months postoperatively and/or follow up CT angiography. All patients had patent grafts during the follow up period and have regained their normal body weight. Immediate and late results, technical details and controversies in open surgical revasculation for chronic mesenteric ischemic disease are reviewed. In conclusion open surgical revasculation for chronic mesenteric ischemic disease is a technically challenging procedure with good results in patients younger than 70 years old , with long occlusions of the splachnic vessels and severe calcification of the vessel wall.