Sigmoidal ischaemia after aortic grafting, detected by endoluminal pulse oximetry.
Colonic ischaemia after abdominal aortic grafting is a severe complication. Late detection of transmural ischaemia will result in a high mortality rate. No simple specific methods are available to detect the early stage. The aim of this pilot study was to detect and monitor sigmoidal ischaemia after aortic surgery with a new endoluminal sigmoidal probe, based on pulse oximetry. Twelve patients with sigmoidal ischaemia were included, the endoluminal probe being introduced into the sigmoid at least 25 cm proximal to the anal verge. It is shown that with this method, mucosal and transmural ischaemia can be graded and differentiated. Patients who showed no wave-form had transmural ischaemia; those with mucosal ischaemia showed reliable wave-forms with oxygen saturation from 40-85%. Colonic ischaemia after aortic grafting can be detected by endoluminal pulse oximetry but the clinical outcome will only improve by early detection in the preclinical stage.
Vahl
A C
AC
Department of Vascular Surgery, Free University Hospital, Amsterdam, The Netherlands.
Nauta
S H
SH
van Rij
G L
GL
Scheffer
G J
GJ
Brom
H L
HL
Rauwerda
J A
JA
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D012809:Colon, Sigmoid / Q000098:blood supply*; D006801:Humans; D007413:Intestinal Mucosa / Q000098:blood supply; D007511:Ischemia / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010092:Oximetry / Q000295:instrumentation*; D010865:Pilot Projects; D011183:Postoperative Complications / Q000175:diagnosis; D011474:Prosthesis Design