Outcome following mesenteric artery revascularisation for chronic mesenteric ischemia

The purpose of this study was to review the clinical presentation and diagnosis of chronic mesenteric ischaemia (CMI) and to evaluate the early results and late outcome of mesenteric revascularisation.

This retrospective study included 15 patients with CMI diagnosed between January 2000 and September 2006. Mesenteric revascularisation was done using either transluminal angioplasty, stenting, endarterectomy or bypass graft. Patients were followed up with Duplex scan and/or computed tomographic angiogram to confirm graft patency.

Sixteen revascularisation procedures were done in 15 patients. Aorto-superior mesenteric artery (SMA) bypass in 9 patients, SMA endarterectomy in 2 patients, transluminal angioplasty in 2 patients, stenting in 2 patients and right common iliac to common hepatic artery bypass in 1 patient with previous failed aorto-SMA graft. There were no perioperative deaths or early procedural complication. Two patients had late graft thrombosis and symptomatic recurrence. One of the three late deaths was due to graft thrombosis and bowel infarction, and the other two died of acute myocardial infarction and disseminated bronchogenic carcinoma respectively.

We conclude that mesenteric revascularisation for CMI is successful for most patients with symptomatic relief, low mortality and a good long term graft patency.