Long-term outcome after mesenteric artery reconstruction: a 37-year experience

Jae-Sung Cho¹, John A Carr, Gordon Jacobsen

¹Division of Vascular Surgery, Department of Surgery, Henry Ford Hospital, Detroit, MI 48202, USA. jcho1@hfhs.org

|March 6, 2002

Summary

Mesenteric artery reconstruction (MAR) for atherosclerotic mesenteric ischemia shows long-term patency and symptom-free survival, particularly for chronic cases. Acute mesenteric ischemia (AMI) remains lethal, but successful MAR offers comparable outcomes to chronic cases.

Area of Science:

Vascular Surgery
Gastroenterology
Cardiovascular Medicine

Background:

Atherosclerotic mesenteric ischemia affects the arteries supplying blood to the intestines.
Mesenteric artery reconstruction (MAR) is a surgical intervention to restore blood flow.
Differentiating outcomes between acute (AMI) and chronic (CMI) mesenteric ischemia is crucial.

Purpose of the Study:

To define the long-term results of mesenteric artery reconstruction (MAR).
To identify factors influencing outcomes after MAR for atherosclerotic mesenteric ischemia.
To compare outcomes between acute mesenteric ischemia (AMI) and chronic mesenteric ischemia (CMI).

Main Methods:

Retrospective review of 48 patients (66 arteries) undergoing MAR for AMI or CMI.
Procedures included bypass grafting, local endarterectomy (LEA), and transaortic endarterectomy (TAE).
Follow-up averaged 5.3 years, assessing patency, recurrence, and survival rates.

Main Results:

Perioperative mortality was 52% for AMI versus 0% for CMI.
Cumulative patency rates were 57% at 5 years and 46% at 10 years.
Transaortic endarterectomy (TAE) showed improved patency over LEA; symptomatic recurrences were linked to superior mesenteric artery (SMA) thrombosis.

Conclusions:

Acute mesenteric ischemia (AMI) is a high-mortality condition, while MAR for chronic mesenteric ischemia (CMI) has low mortality.
Successful MAR for AMI can achieve long-term patency and symptom-free survival comparable to CMI.
Elective MAR for CMI is recommended, with long-term surveillance advised.

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Long-term outcome after mesenteric artery reconstruction: a 37-year experience

Area of Science:

Background:

Purpose of the Study:

Main Methods:

Main Results:

Conclusions:

Related Concept Videos

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