Surgical management of chronic intestinal ischemia: a reappraisal.
Fifty-six patients with chronic intestinal ischemia underwent surgical revascularization. All patients had abdominal pain, 98% experienced significant weight loss, and 75% had an abdominal bruit. Visceral artery occlusive disease was documented by angiography in all patients; 77% of our patients had multiple-vessel occlusive disease, and 23% had single-vessel involvement of either the celiac or the superior mesenteric artery. The mortality rate was 8.9%. Ninety-six percent of the survivors were completely relief of symptoms, but an overall late recurrence rate was noted in 26.5%. Fifty-nine percent of our patients underwent revascularization of all stenotic vessels. Complete revascularization in multiple-vessel disease resulted in a late recurrence rate of 11%. When two of three stenotic vessels were revascularized, there was a 29% recurrence rate, and when one of three stenotic vessels was revascularized, there was a 50% recurrence rate. These findings suggest that although single-vessel revascularization may relieve symptoms, the optimal long-term result can be obtained by complete revascularization of all stenotic vessels.
D000005:Abdomen; D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000601:surgery; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D001835:Body Weight; D002908:Chronic Disease; D004691:Endarterectomy; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000601:surgery*; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene; D012008:Recurrence; D014680:Veins / Q000637:transplantation
D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene