title: Chronic mesenteric ischemia and therapeutic paradigm of mesenteric revascularization.
abstract: Chronic mesenteric ischemia is a life-threatening clinical problem resulting in death from inanition and/or bowel infarction, if left untreated, albeit low disease prevalence. Typical presentation is postprandial abdominal pain, severe weight loss, and altered bowel habit. Surgical revascularization of the superior mesenteric artery provides effective long-term treatment for chronic intestinal ischemia. Eleven patients underwent superior mesenteric artery revascularization, nine of them with open retrograde superior mesenteric artery bypass and two with angioplasty and stenting. All patients except one made a satisfactory recovery in this cohort. Major complication included one graft thrombosis leading to bowel ischemia and death. The rest all recovered weight in 3-6 months with a follow up period of 6 to 28 months. Two patients had recurrence of symptoms due to failing bypass requiring stenting for assisted primary patency. Superior mesenteric artery revascularization can be performed with minimal morbidity and mortality, providing excellent symptom relief and quality of life.
authors.affiliation: Division of Vascular Surgery, Department of Cardiovascular and Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Medical College PO, Trivandrum, 695 011, India.
authors.forename: Shashidhar Kallappa
authors.initials: SK
authors.lastname: Parameshwarappa
authors.forename: Ajay
authors.initials: A
authors.lastname: Savlania
authors.forename: Sidharth
authors.initials: S
authors.lastname: Viswanathan
authors.forename: Srinivas
authors.initials: S
authors.lastname: Gadhinglajkar
authors.forename: Kapilamoorthy Tirur
authors.initials: KT
authors.lastname: Raman
authors.forename: Madathipat
authors.initials: M
authors.lastname: Unnikrishnan
mesh_terms: D000328:Adult; D000368:Aged; D017130:Angioplasty / Q000379:methods; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000601:surgery*; D065666:Mesenteric Ischemia / Q000601:surgery*; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*