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Related Experiment Videos

Reoperation for recurrent chronic visceral ischemia

D B Schneider1, P A Schneider, L M Reilly

  • 1Department of Surgery, University of California, San Francisco, 94143, USA.

Journal of Vascular Surgery
|March 24, 1998
PubMed
Summary

Recurrent visceral ischemia is a significant concern after initial revascularization. Reoperation for chronic recurrent visceral ischemia offers safe and effective symptom relief and durable survival rates.

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Area of Science:

  • Vascular Surgery
  • Gastrointestinal Surgery
  • Interventional Cardiology

Background:

  • Recurrent visceral ischemia affects up to one-third of patients post-revascularization.
  • Management strategies for recurrent visceral ischemia remain incompletely described.
  • This study addresses the clinical presentation, surgical management, and outcomes of recurrent visceral ischemia.

Purpose of the Study:

  • To analyze the presentation of recurrent visceral ischemia.
  • To evaluate the surgical management of recurrent visceral ischemia.
  • To determine the outcomes, including survival rates, following reoperation for recurrent visceral ischemia.

Main Methods:

  • A retrospective review of 109 patients undergoing primary visceral revascularization between 1959 and 1997.

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  • Analysis of 24 patients who underwent 30 reoperations for recurrent visceral ischemia (12 chronic, 7 acute).
  • Symptom-free and overall survival rates were calculated using life table analysis.

    • Main Results:

    • Recurrent acute visceral ischemia had a high mortality rate (85.7%).
    • Reoperation for chronic recurrent visceral ischemia involved antegrade aortovisceral bypass or transaortic visceral endarterectomy.
    • First reoperations had a 6.7% mortality and 33.3% complication rate, with 77.3% symptom-free survival at 1 year.

    Conclusions:

    • Recurrent visceral ischemia is a frequent complication of primary visceral revascularization.
    • Reoperation for recurrent chronic visceral ischemia is safe and effective.
    • Repeat visceral revascularization provides durable symptom relief and comparable life expectancy to primary procedures.