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.
Division of Vascular Surgery, Oregon Health and Sciences University, Portland, OR 97201, USA.
Mary E
ME
Giswold
Gregory J
GJ
Landry
Lloyd M
LM
Taylor
Gregory L
GL
Moneta
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