Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Intestinal ischemia complicating abdominal aortic surgery.

D C Brewster1, D P Franklin, R P Cambria

  • 1Vascular Surgery Division, Massachusetts General Hospital, Boston.

Surgery
|April 1, 1991
PubMed
Summary

This study reviews 2,137 patients who underwent abdominal aortic surgery to identify the frequency and causes of bowel blood flow loss. Researchers found that this rare but dangerous complication often relates to specific surgical techniques and patient anatomy. Early identification of risk factors helps surgeons choose safer operative approaches.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

The effects of brain death and ischemia on tolerance induction are organ-specific.

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons·2018
Same author

Predictors of early graft failure after infrainguinal bypass surgery: a risk-adjusted analysis from the NSQIP.

European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery·2012
Same author

Characterization of the atherosclerotic carotid bifurcation using MRI, finite element modeling, and histology.

Annals of biomedical engineering·2004
Same author

Evaluation of peripheral arterial occlusive disease and postsurgical viability using reflectance spectroscopy of skin.

Microvascular research·2004
Same author

Clinical potential of photodynamic therapy in cardiovascular disorders.

American journal of cardiovascular drugs : drugs, devices, and other interventions·2004
Same author

[Photodynamic therapy in cardiac and vascular surgery].

Il Giornale di chirurgia·2003

Area of Science:

  • Vascular surgery outcomes research within intestinal ischemia medicine
  • Clinical epidemiology of postoperative complications

Background:

No prior work had fully resolved the specific clinical and anatomical drivers behind bowel blood flow loss following aortic reconstruction. Prior research has shown that this rare complication carries significant mortality risks for patients. That uncertainty drove this comprehensive review of a large patient cohort over nine years. It was already known that surgical interventions on the aorta can disrupt blood supply to the digestive tract. This gap motivated an examination of how specific technical maneuvers influence postoperative outcomes. Understanding these variables is necessary to improve patient safety during vascular procedures. Previous studies often lacked the sample size required to isolate these rare events effectively. This investigation addresses those limitations by analyzing over two thousand surgical cases to clarify risk profiles.

Purpose Of The Study:

The aim of this study is to determine the incidence and clinical factors associated with bowel blood flow loss after aortic reconstruction. Researchers sought to clarify how specific technical maneuvers contribute to this rare complication. This investigation addresses the uncertainty regarding why some patients develop damage while others do not. The team examined a large cohort to identify anatomical and surgical predictors of poor outcomes. They intended to provide surgeons with better tools for risk assessment before performing complex procedures. This work focuses on distinguishing between elective and emergency surgical scenarios. The authors also aimed to evaluate the role of preoperative imaging in preventing these adverse events. By analyzing these variables, the study provides a foundation for developing safer operative strategies in vascular medicine.

Keywords:
vascular complicationsaortic reconstructionbowel perfusionsurgical outcomes

Frequently Asked Questions

According to the authors, the primary outcome is the development of overt bowel damage, which occurred in 1.1% of the cohort. This condition was confirmed through surgical re-exploration or direct visualization via endoscopic procedures.

The researchers highlight that the inferior mesenteric artery is a key anatomical structure. Ligation of this vessel was present in 74% of patients who developed colon-specific tissue damage.

The investigators state that preoperative angiography is necessary to evaluate risk. This imaging modality helps surgeons identify patients who might suffer from impaired collateral blood flow before the procedure starts.

The team notes that colonoscopy serves as the most reliable diagnostic tool. This procedure allows clinicians to confirm the presence of tissue injury after patients present with postoperative symptoms like bloody diarrhea.

Related Experiment Videos

Main Methods:

Review approach involved a retrospective analysis of 2,137 patients who underwent infrarenal aortic reconstruction. The study team examined clinical records spanning a nine-year period to identify postoperative complications. Investigators categorized patients based on the specific type of aortic procedure performed. They evaluated preoperative, intraoperative, and anatomical variables to determine associations with bowel damage. Diagnostic criteria relied on findings from reoperation or endoscopic evaluations. The researchers compared outcomes between elective and emergency surgical cases. They assessed the impact of vessel ligation and collateral circulation status on patient health. This systematic evaluation provided a detailed look at the multifactorial nature of these rare vascular events.

Main Results:

Key findings from the literature reveal that 24 patients, or 1.1% of the cohort, experienced overt bowel blood flow loss. Colon damage occurred in 19 individuals, while 5 patients suffered from small bowel injury. The data show that patients with ruptured aneurysms or those requiring reoperative graft replacement faced higher risks. Ligation of a patent inferior mesenteric artery appeared in 74% of colon damage cases. Small bowel injury was linked to superior mesenteric artery disease or the use of suprarenal clamping. The overall mortality rate reached 25% across the entire group of affected patients. This mortality figure jumped to 50% for those who required surgical resection of the bowel. These results demonstrate that while the complication is infrequent, its clinical impact is substantial.

Conclusions:

The authors conclude that bowel blood flow loss remains a rare but severe complication following aortic reconstruction. Synthesis and implications suggest that identifying high-risk individuals allows for tailored surgical strategies to mitigate these dangers. Clinical evidence indicates that patients undergoing reoperative procedures or those with ruptured aneurysms face elevated risks. The researchers propose that preoperative imaging is vital for assessing potential vascular compromise before surgery begins. Findings show that ligation of specific vessels frequently correlates with colon damage. The data highlight that early recognition of symptoms like bloody diarrhea is necessary to prevent poor outcomes. The investigators emphasize that mortality rates increase significantly when surgical resection becomes necessary for the bowel. This review underscores the importance of careful operative planning to protect intestinal perfusion during complex vascular repairs.

The study reports an overall mortality rate of 25% for affected patients. This figure increases to 50% for individuals who require surgical removal of necrotic bowel segments.

The researchers propose that surgeons should adopt specific operative strategies based on identified risk factors. They suggest that proactive planning can reduce the occurrence of these dangerous ischemic events.