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Mesenteric revascularization during aneurysmectomy

M C Donaldson1, M Belkin, A D Whittemore

  • 1Department of Surgery, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

The Surgical Clinics of North America
|April 1, 1997
PubMed
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Aortic aneurysm surgery risks compromising mesenteric blood flow. Surgeons must preserve visceral blood flow, with revascularization considered for specific cases to improve outcomes in mesenteric occlusive disease.

Area of Science:

  • Vascular Surgery
  • Abdominal Aortic Aneurysm
  • Mesenteric Circulation

Background:

  • Aortic aneurysm surgery poses a risk of compromising mesenteric blood flow.
  • Preserving visceral blood flow is a critical objective during these procedures.

Purpose of the Study:

  • To review the association between aortic aneurysm surgery and mesenteric circulation.
  • To discuss methods for preserving visceral blood flow during aneurysmectomy.
  • To evaluate the role of revascularization in mesenteric occlusive disease and combined surgery for ischemic symptoms.

Main Methods:

  • Review of surgical techniques for suprarenal abdominal and thoracoabdominal aneurysmectomy.
  • Discussion of revascularization strategies (endarterectomy, bypass) for mesenteric occlusive disease.

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  • Analysis of outcomes for patients undergoing combined surgery for aneurysm and mesenteric ischemia.

    • Main Results:

    • Preservation of visceral blood flow is paramount in aortic aneurysm surgery.
    • Revascularization may benefit selected cases of advanced mesenteric occlusive disease.
    • Combined surgery offers clear benefits for patients with mesenteric ischemic symptoms during aneurysmectomy.

    Conclusions:

    • Surgical techniques have evolved to better preserve mesenteric blood flow during aortic aneurysm repair.
    • Prophylactic revascularization for mesenteric occlusive disease requires further investigation.
    • Simultaneous surgical intervention is beneficial for patients presenting with mesenteric ischemia and aortic aneurysms.