title: A comparison of antegrade and retrograde mesenteric bypass.
abstract: Mesenteric artery bypass originating from the supraceliac aorta (antegrade bypass) has been the standard orientation of visceral artery bypass grafts. Retrograde bypass, in which the bypass originates from the iliac arteries, has not been as widely accepted. The purpose of our study was to compare the results of these two types of bypass in a similar population. We retrospectively reviewed the records of patients undergoing mesenteric artery bypass at two tertiary care medical centers (UCLA Medical Center, Beth Israel Deaconess Medical Center). Between February 1992 and January 2001, 37 patients underwent 39 mesenteric bypass procedures. The choice of bypass orientation (antegrade versus retrograde) was determined by the individual surgeon. Chart review, duplex ultrasonography, and/or telephone interviews were used to assess symptom-free survival. Actuarial analysis was completed using Kaplan-Meier survival estimates. From this assessment we were able to determine that symptom-free survival of patients undergoing retrograde mesenteric bypass is similar to that seen in antegrade bypass. Primary retrograde bypass is a valid option for patients undergoing mesenteric bypass.
authors.affiliation: Division of Vascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. nkansal@ucsd.edu
authors.forename: Nikhil
authors.initials: N
authors.lastname: Kansal
authors.forename: Frank W
authors.initials: FW
authors.lastname: LoGerfo
authors.forename: Alana K
authors.initials: AK
authors.lastname: Belfield
authors.forename: Frank B
authors.initials: FB
authors.lastname: Pomposelli
authors.forename: Allen D
authors.initials: AD
authors.lastname: Hamdan
authors.forename: Niren
authors.initials: N
authors.lastname: Angle
authors.forename: David R
authors.initials: DR
authors.lastname: Campbell
authors.forename: Abiram
authors.initials: A
authors.lastname: Sridhar
authors.forename: Julie A
authors.initials: JA
authors.lastname: Freischlag
authors.forename: William
authors.initials: W
authors.lastname: Quiñones-Baldrich
mesh_terms: D000368:Aged; D001900:Boston / Q000453:epidemiology; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007511:Ischemia / Q000150:complications / Q000453:epidemiology / Q000601:surgery; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D017538:Mesenteric Artery, Superior / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology; D014656:Vascular Surgical Procedures