Endovascular treatment as a bridge to successful surgical revascularization for chronic mesenteric ischemia

Matthias Biebl, W. Andrew Oldenburg, Ricardo Paz-Fumagalli, J. Mark Mckinney, Albert Hakaim

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Chronic mesenteric ischemia (CMI) can be treated with surgical revascularization or with angioplasty and stenting. As experience has been gained, endovascular treatment appears safe and effective in selected patients. Currently, surgical revascularization has better success and patency rates but also a higher short- and midterm mortality and morbidity, especially in patients at high surgical risk. A 72-year-old female with severe respiratory dysfunction presented with CMI resulting in profound malnutrition. Serial percutaneous interventions averted urgent surgery and reversed the mesenteric ischemia. Nine months later, after repeated angioplasty and stenting had failed, elective uncomplicated iliomesenteric bypass, in a medically optimized patient, resolved the ischemia. At an 18-month follow-up, the graft remained widely patent and the patient asymptomatic with a body weight corresponding to her ideal body weight. Compared to surgical revascularization, reocclusion or restenosis occurs more frequently after endovascular treatment of CMI, and reintervention may be necessary. Nevertheless, percutaneous intervention effectively provides relief from mesenteric ischemia and has lower perioperative complication rates compared to surgery in patients at high surgical risk. After initial relief of the CMI, the patient's condition may improve, allowing for more definitive secondary surgical revascularization, if needed.

Original languageEnglish (US)
Pages (from-to)994-998
Number of pages5
JournalAmerican Surgeon
Volume70
Issue number11
StatePublished - 2004

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Angioplasty
Therapeutics
Ideal Body Weight
Malnutrition
Mesenteric Ischemia
Ischemia
Body Weight
Morbidity
Transplants
Mortality

ASJC Scopus subject areas

  • Surgery

Cite this

Biebl, M., Oldenburg, W. A., Paz-Fumagalli, R., Mckinney, J. M., & Hakaim, A. (2004). Endovascular treatment as a bridge to successful surgical revascularization for chronic mesenteric ischemia. American Surgeon, 70(11), 994-998.

Endovascular treatment as a bridge to successful surgical revascularization for chronic mesenteric ischemia. / Biebl, Matthias; Oldenburg, W. Andrew; Paz-Fumagalli, Ricardo; Mckinney, J. Mark; Hakaim, Albert.

In: American Surgeon, Vol. 70, No. 11, 2004, p. 994-998.

Research output: Contribution to journalArticle

Biebl, M, Oldenburg, WA, Paz-Fumagalli, R, Mckinney, JM & Hakaim, A 2004, 'Endovascular treatment as a bridge to successful surgical revascularization for chronic mesenteric ischemia', American Surgeon, vol. 70, no. 11, pp. 994-998.
Biebl, Matthias ; Oldenburg, W. Andrew ; Paz-Fumagalli, Ricardo ; Mckinney, J. Mark ; Hakaim, Albert. / Endovascular treatment as a bridge to successful surgical revascularization for chronic mesenteric ischemia. In: American Surgeon. 2004 ; Vol. 70, No. 11. pp. 994-998.
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