title: Surgical treatment of chronic multivascular mesenteric ischemia in a patient with antiphospholipid syndrome, abdominal aortic aneurism, and renal cancer: when planning overwhelms complexity.
abstract: Chronic mesenteric ischemia is a clinical condition caused by obstructive or occlusive disease of the mesenteric vessels, with potentially lethal consequences. We describe a case of open multiple revascularization in a patient affected by antiphospholipid syndrome and diffuse atherosclerosis, with an abdominal aortic aneurism, a contracted kidney, a renal cancer affecting the contralateral kidney, and as a consequence, a chronic renal failure and hypertension. We revascularized the celiac trunk, the superior and inferior mesenteric arteries, and the right renal artery using saphenous grafts; the aneurism was corrected, and the renal tumor was treated by radiofrequency ablation. Despite the invasiveness and complexity, the surgical strategy adopted allowed to save the patient's life, to treat the chronic mesenteric ischemia and the renal cancer, and to improve the chronic renal insufficiency and hypertension.
  
  
  BACKGROUND
  Graft, Mesenteric ischemia, Occlusion, Revascularization.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Paliogiannis
authors.forename: Giorgio Carlo
authors.initials: GC
authors.lastname: Ginesu
authors.forename: Claudio Francesco
authors.initials: CF
authors.lastname: Feo
authors.forename: Maria Laura
authors.initials: ML
authors.lastname: Cossu
authors.forename: Antonio
authors.initials: A
authors.lastname: Pinna
authors.forename: Giulia
authors.initials: G
authors.lastname: Farina
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Vidili
authors.forename: Alberto
authors.initials: A
authors.lastname: Porcu
mesh_terms: D016736:Antiphospholipid Syndrome / Q000150:complications*; D017544:Aortic Aneurysm, Abdominal / Q000150:complications*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D017115:Catheter Ablation; D002445:Celiac Artery / Q000601:surgery; D000072226:Computed Tomography Angiography; D006801:Humans; D006973:Hypertension / Q000150:complications; D007676:Kidney Failure, Chronic / Q000209:etiology; D007680:Kidney Neoplasms / Q000150:complications* / Q000601:surgery; D008297:Male; D008638:Mesenteric Arteries / Q000601:surgery; D065666:Mesenteric Ischemia / Q000150:complications / Q000601:surgery*; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D012077:Renal Artery / Q000601:surgery; D012501:Saphenous Vein / Q000637:transplantation
chemical_list: D011093:Polyethylene Terephthalates