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Transaortic mesenteric endarterectomy

K J Hansen1, J S Deitch

  • 1Department of General Surgery, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina, USA.

The Surgical Clinics of North America
|April 1, 1997
PubMed
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For mesenteric artery disease causing visceral ischemia, antegrade aortomesenteric bypass or transaortic mesenteric endarterectomy are recommended surgical treatments. Intraoperative duplex sonography is crucial for ensuring repair adequacy and long-term success.

Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Interventional Cardiology

Background:

  • Atherosclerotic stenosis and occlusion of mesenteric vessels can lead to acute or chronic visceral ischemia.
  • Various surgical methods exist for mesenteric artery reconstruction, but optimal approaches for complex disease remain debated.

Purpose of the Study:

  • To evaluate the efficacy of antegrade aortomesenteric bypass and transaortic mesenteric endarterectomy for managing visceral ischemia due to mesenteric artery disease.
  • To highlight the importance of intraoperative assessment for ensuring successful mesenteric artery repair.

Main Methods:

  • Review of surgical techniques for mesenteric artery reconstruction, focusing on antegrade bypass and transaortic endarterectomy.
  • Emphasis on the role of intraoperative duplex sonography in assessing technical adequacy and patency.

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Main Results:

  • Antegrade aortomesenteric bypass is versatile and suitable for extensive mesenteric disease.
  • Transaortic mesenteric endarterectomy is effective, particularly when combined with simultaneous renal artery endarterectomy for coexisting osteal atherosclerosis.

Conclusions:

  • Antegrade bypass and transaortic endarterectomy are the preferred methods for managing mesenteric artery atherosclerotic disease causing visceral ischemia.
  • Intraoperative duplex sonography is essential for confirming technical success and ensuring long-term patency of mesenteric reconstructions.