Chronic mesenteric arterial insufficiency: results of revascularization in 33 cases

The symptoms of mesenteric arterial insufficiency and the advantages of surgical revascularization have become widely recognized in recent years. Follow-up data are accumulating on patients who have had surgery for revascularization. In this study we report on 33 patients who had mesenteric revascularization for intestinal angina. Twenty-nine patients presented with postprandial pain; most had weight loss. Abdominal bruits were heard preoperatively in 26 patients. Aortogram demonstrated involvement of one mesenteric vessel in 13 (39%) patients and two or more vessels in 20 (61%). Revascularization was accomplished with the use of a Dacron graft or an autogenous vein bypass graft to 48 vessels. Endarterectomy and patch angioplasty were done once. One patient died in the early postoperative period. Of the other 32 patients, 30 (94%) had relief of symptoms. Eight patients died from 8 to 135 months after operation, but only one died from mesenteric vascular occlusion and bowel infarction. Five years after operation, 83% of the patients were alive; in ten years, 62%.