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Cited by 90Abdominal vascular conditions and treatmentsInfectious Aortic and Vascular ConditionsPeripheral Artery Disease Management

Durability of antegrade synthetic aortomesenteric bypass for chronic mesenteric ischemia

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Jimenez, Javier G., Huber, Thomas S., Ozaki, C.Keith, Flynn, Timothy C., Berceli, Scott A., Lee, W.Anthony, Seeger, James M.·2002·Journal of Vascular Surgery
DOI 10.1067/mva.2002.124377
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Abstract

Objective The optimal treatment (endovascular/open repair, conduit, configuration) for chronic mesenteric ischemia (CMI) remains unresolved. This study was designed to review the outcome of patients with CMI treated with antegrade synthetic aortomesenteric bypass.Methods The study was designed as a retrospective review in an academic tertiary care medical center. Patients with CMI who underwent antegrade synthetic aortomesenteric bypass were identified from a computerized vascular registry (from January 1987 to January 2001) with antegrade synthetic aortomesenteric bypass as intervention. Outcome measures were functional outcome (symptom relief, weight gain) and both graft patency (duplex ultrasound/angiography) and survival rates as determined with life-table analysis.Results Forty-seven patients (female, 70%; age, 62 +/- 12 years) underwent aortomesenteric bypass (aortoceliac/aortosuperior mesenteric, n = 45; aortosuperior mesenteric, n = 2) for CMI (abdominal pain, 98%; weight loss, 83%). In-hospital mortality rate was 11% (four multiple organ dysfunction, one bowel infarction), mean length of stay was 32 +/- 30 days, three patients (6%) were discharged to a nursing home, and one (2%) was discharged home on parenteral nutrition (duration 4 months). At a mean follow-up period of 31 +/- 27 months, all patients had relief of abdominal pain and 86% had gained weight (at > or =1 year follow-up: mean ideal body weight 103 +/- 22%; versus before surgery: 87 +/- 17%; P <.001). Fourteen patients (34%) had diarrhea at discharge that persisted more than 6 months in 10. One patient had acute mesenteric ischemia develop from a failed graft (at 20 months), two patients had recurrent CMI develop from failing grafts (at 46 months and 49 months), and one asymptomatic patient was found to have a failing graft with duplex ultrasound scan (at 17 months); all grafts were revised. Primary, primary assisted, and secondary 5-year graft patency rates with life-table analysis were 69% (standard error [SE], 17%), 94% (SE, 7%), and 100%, respectively, and the 5-year survival rate was 74% (SE, 12%).Conclusion Antegrade synthetic aortomesenteric bypass for CMI is associated with good functional outcome and long-term graft patency.

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Authors
Jimenez, J. G., Huber, T. S., Ozaki, C. K., Flynn, T. C., Berceli, S. A., Lee, W. A., & Seeger, J. M.
Affiliations
  • University of Florida Health (US)
  • University of Florida (US)
ORCID
Venue
Journal of Vascular Surgery
Publisher
Elsevier BV
Published
2002-06
Volume
35
Issue
6
Pages
1078-1084
ISSN
0741-5214 (ISSN-L)
DOI
10.1067/mva.2002.124377
OpenAlex
W2092541512
Cited by
90
References
16
Citations by year
2026: 4 · 2025: 4 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 5 · 2017: 2 · 2016: 1 · 2015: 4 · 2014: 3 · 2013: 5 · 2012: 5
FWCI
2.22
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Vascular Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
  • Health Sciences › Medicine › Surgery › Infectious Aortic and Vascular Conditions
  • Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
Keywords
chronic mesenteric ischemia, graft patency, graft failure, graft revision, weight gain, abdominal pain relief, acute mesenteric ischemia, endovascular repair, postoperative complications, parenteral nutrition, multiple organ failure
MeSH terms
Aorta, Abdominal, Arterial Occlusive Diseases, Chronic Disease, Female, Follow-Up Studies, Humans, Ischemia, Male, Mesenteric Arteries, Mesenteric Vascular Occlusion, Middle Aged, Registries, Retrospective Studies, Time Factors, Vascular Patency, Treatment Outcome, Blood Vessel Prosthesis Implantation

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