Outcomes after redo procedures for failed mesenteric revascularization.
This report examines results of mesenteric revascularization following a failed splanchnic revascularization. Patients undergoing repeat mesenteric revascularization from January 1985 to July 2002 were identified from a prospectively maintained registry. Data recorded included procedures performed, perioperative mortality, complications, and operative indications. Patients who had embolic events were excluded. Eighty-six patients underwent 105 mesenteric interventions in this time period; 22 patients underwent 33 repeat mesenteric revascularization procedures. There were 25 single-vessel bypasses, 3 multivessel reconstructions, 3 angioplasty procedures (1 open, 2 percutaneous), and 2 graft thrombectomies. Complications occurred in 33.3%. Perioperative mortality was 6.1%, all in patients with acute mesenteric ischemia. One- and 4-year primary patency for repeat mesenteric revascularization was 73.5% and 62.2%, respectively, and survival for repeat mesenteric revascularization was 85.9% and 75.5%, respectively. Patients surgically treated for mesenteric ischemia can require additional interventions. Repeat revascularization effectively prolongs survival when an earlier intervention fails.
Giswold
Mary E
ME
Division of Vascular Surgery, Oregon Health and Sciences University, Portland, OR 97201, USA.
Landry
Gregory J
GJ
Taylor
Lloyd M
LM
Moneta
Gregory L
GL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019917:Blood Vessel Prosthesis Implantation; D015897:Comorbidity; D004691:Endarterectomy; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D007511:Ischemia / Q000453:epidemiology / Q000601:surgery*; D015993:Life Tables; D008297:Male; D017538:Mesenteric Artery, Superior / Q000601:surgery*; D008875:Middle Aged; D012086:Reoperation; D013152:Splanchnic Circulation; D017211:Treatment Failure; D014654:Vascular Patency; D014656:Vascular Surgical Procedures