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Mesenteric artery bypass: objective patency determination

W D McMillan1, W J McCarthy, M R Bresticker

  • 1Department of Surgery, McGaw Medical Center, Northwestern University Medical School, Chicago, IL, USA.

Journal of Vascular Surgery
|May 1, 1995
PubMed
Summary
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Splanchnic bypass surgery offers durable revascularization for mesenteric ischemia, achieving an 89% primary patency rate at 72 months. Objective follow-up using duplex scanning is crucial for accurate assessment of graft success.

Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Medical Imaging

Background:

  • Symptomatic follow-up is insufficient for assessing reconstructive techniques in intestinal ischemia.
  • Objective measurement of patency rates is needed for splanchnic bypass grafts.

Purpose of the Study:

  • To determine primary patency rates of splanchnic bypass grafts for atherosclerotic occlusive disease.
  • To evaluate objective follow-up methods like mesenteric duplex ultrasound and arteriography.

Main Methods:

  • 38 splanchnic bypass grafts were placed in 25 patients with acute or chronic mesenteric ischemia.
  • Graft patency was monitored using duplex scanning or arteriography.
  • Life-table and log rank analysis were used to assess outcomes.

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Main Results:

  • The life-table primary patency rate was 89% at 72 months.
  • Symptomatic follow-up had only 33% sensitivity for detecting graft occlusion.
  • No significant difference in patency was found between antegrade and retrograde bypass, or between saphenous vein and polytetrafluoroethylene grafts.

Conclusions:

  • Splanchnic bypass is a durable revascularization method for mesenteric ischemia.
  • Objective assessment, particularly with duplex scanning, is critical for accurate patency rate measurement.
  • Long-term patency for acute and chronic ischemia did not significantly differ.