Open surgical treatment for chronic mesenteric ischemia in the endovascular era: When it is necessary and what is the preferred technique?

Gustavo S. Oderich, Peter Gloviczki, Thomas C. Bower

Research output: Contribution to journalArticle

41 Scopus citations

Abstract

Treatment of chronic mesenteric ischemia has evolved during the last 2 decades. Endovascular treatment has first emerged as an alternative to bypass in the elderly or higher-risk patient, but has become the primary modality of treatment in most patients with suitable lesions, independent of their surgical risk. Open mesenteric revascularization with bypass or (rarely) endarterectomy still has an important role in the treatment of patients with more extensive disease, including long-segment or flush occlusions, small vessel size, multiple tandem lesions, and severe calcification. Our preference for open reconstruction in good-risk patients with multivessel disease is a supraceliac aorta to celiac and superior mesenteric artery (SMA) bypass, whereas an iliac artery to SMA bypass or, occasionally, an infrarenal aortic to SMA bypass is used in the higher-risk group. In this article, we summarize the selection criteria, techniques, and outcomes of open mesenteric reconstruction in the endovascular era.

Original languageEnglish (US)
Pages (from-to)36-46
Number of pages11
JournalSeminars in Vascular Surgery
Volume23
Issue number1
DOIs
StatePublished - Mar 1 2010

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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