Influence of complete revascularization on chronic mesenteric ischemia.
Complete revascularization for chronic intestinal ischemia is controversial. Fifty-eight patients (119 arteries) underwent mesenteric revascularization between 1981 and 1988. There were 46 women and 12 men (mean age: 63 years). Sixty percent of patients had three-vessel disease. Twenty-one patients underwent concomitant aortic reconstruction. Operative mortality was 10%. Four of the six deaths occurred in patients undergoing aortic surgery. Late graft failure occurred in five patients (10%). Five-year survival for patients with three-vessel involvement who underwent three-vessel repair was 73%, compared with 57% for two-vessel repair and 0% for one-vessel repair (p = NS). Similarly, graft patency in patients with three-vessel disease was highest in those patients who had complete revascularization (90%, 54%, and 0%, respectively) (p = NS). We conclude that increased graft patency and survival in patients with three-vessel disease was most frequent with complete revascularization. Diseased inferior mesenteric arteries should be repaired if feasible. Concomitant aortic operations should be avoided if possible.
McAfee
M K
MK
Department of Surgery, Mayo Clinic, Rochester, MN 55905.
Cherry
K J
KJ
Naessens
J M
JM
Pairolero
P C
PC
Hallett
J W
JW
Gloviczki
P
P
Bower
T C
TC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000601:surgery; D001807:Blood Vessel Prosthesis; D002908:Chronic Disease; D003327:Coronary Disease / Q000150:complications; D004691:Endarterectomy; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000401:mortality / Q000601:surgery*; D008297:Male; D008643:Mesentery / Q000098:blood supply* / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D012307:Risk Factors; D015996:Survival Rate; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000379:methods