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Titolo:
Distal thoracic aorta as inflow for the treatment of chronic mesenteric ischemia
Autore:
Farber, MA; Carlin, RE; Marston, WA; Owens, LV; Burnham, SJ; Keagy, BA;
Indirizzi:
Univ N Carolina, Div Vasc Surg, Chapel Hill, NC 27599 USA Univ N CarolinaChapel Hill NC USA 27599 Surg, Chapel Hill, NC 27599 USA
Titolo Testata:
JOURNAL OF VASCULAR SURGERY
fascicolo: 2, volume: 33, anno: 2001,
pagine: 281 - 287
SICI:
0741-5214(200102)33:2<281:DTAAIF>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
CHRONIC VISCERAL ISCHEMIA; CHRONIC INTESTINAL ISCHEMIA; SURGICAL-MANAGEMENT; OCCLUSIVE DISEASE; REVASCULARIZATION; BYPASS; ARTERY; CIRCULATION; GRAFTS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
30
Recensione:
Indirizzi per estratti:
Indirizzo: Farber, MA Univ N Carolina, Div Vasc Surg, Campus Box 7212,210 Burnett Womack, ChapelHill, NC 27599 USA Univ N Carolina Campus Box 7212,210 Burnett Womack Chapel Hill NC USA 27599
Citazione:
M.A. Farber et al., "Distal thoracic aorta as inflow for the treatment of chronic mesenteric ischemia", J VASC SURG, 33(2), 2001, pp. 281-287

Abstract

Purpose: Mesenteric revascularization for chronic mesenteric ischemia (CMI) traditionally involves antegrade or retrograde bypass graft originating from the supraceliac or infrarenal aorta. The distal thoracic aorta (DTA) may provide a better inflow source than the abdominal aorta. The purpose of this study was to evaluate the results with the DTA used as inflow for the surgical treatment of CMI. Methods: All patients undergoing mesenteric revascularization for CMI withgrafts originating from the DTA were identified from 1990 to 1999. A ninthinterspace thoracoretroperitoneal incision was used for exposure, and distal aortic flow was maintained by use of a partial occlusion clamp. Results: Eighteen consecutive patients with CMI underwent mesenteric bypass grafting with the DTA used as inflow. All patients were admitted with chronic abdominal pain or weight loss, with two (12%) requiring urgent revascularization because of acute exacerbation of chronic symptoms. Fourteen (78%) patients had both celiac and superior mesenteric artery bypass grafts plated, and three (17%) patients had superior mesenteric artery grafts alone. There was one (6%) perioperative death and three (17%) major complications. There was no kidney failure, mesenteric infarction, or spinal cord ischemia. The life-table survival rate was 89%, 89%, and 76% at 1, 3, and 5 years,respectively. All 18 patients remained symptom free and required no additional procedures to assist patency. There was no evidence of graft stenosis or occlusion (100% patency) for those grafts evaluated objectively during the mean follow-up of 34.8 months (range, 1-97 months). Conclusions: Antegrade mesenteric revascularization with the DTA used as inflow is associated with low morbidity and mortality rates. Furthermore, itprovides excellent midterm patency and survival results and should be considered as a primary approach for reconstruction of patients with CMI.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/03/20 alle ore 22:58:44