[Chronic mesenteric ischemia--surgical therapy in 3 level occlusion]

A 57-year-old patient with general arteriosclerosis and end-stage renal failure was found to be suffering from occlusion of the mesenteric arteries. The symptoms were rapidly progressive. The aortogram showed that nutrition of the whole intestine took place via a collateral vessel that originated at both internal iliac arteries. Revascularization of the superior mesenteric artery with interposition of Gore-Tex prosthesis and transposition to the aorta were performed. The postoperative course was uncomplicated, but prolonged due to the accompanying diseases. In conclusion, single-vessel revascularization for chronic intestinal ischemia is a safe and sufficient procedure. Interpositioning of a graft and transposition to the aorta have the advantages of infrarenal access with an antegrade blood flow and no kinking of the prosthesis.