Mesenteric arterial bypass grafts: early and late results and suggested surgical approach for chronic and acute XXXX .

@entity1 @entity353 @entity63 @entity294 @entity6029 @entity530 @entity951 @entity1188 @entity439 @entity7140 @entity715 @entity850 @entity1142 @entity5327
BACKGROUND: The purposes of this study were to determine the early and late results of placement of arterial bypass grafts in the treatment of chronic and acute @entity63 and to ascertain whether multiple grafts provide better late results than a single graft. METHODS: Records of 34 @entity1 who underwent mesenteric vascular graft placement were retrospectively reviewed. RESULTS: All 21 @entity1 with chronic @entity63 had a history of @entity951 and @entity353 . Food fear was reported by 33% of @entity1 ; also, @entity294 in 57%, @entity1142 in 29%, @entity7140 in 19%, @entity63 or peptic ulcer in 19%, and elevation of liver enzymes in 22% were reported. Angiogram showed more than 50% @entity850 or occlusion of the superior mesenteric artery (SMA) in 100% of @entity1 , celiac artery in 90%, and inferior mesenteric artery in 90%. Although not described previously, a reduction in collateral flow from the internal iliac arteries was caused by severe @entity530 in 56% of @entity1 . There were no in-hospital deaths. The rate of survival at 1 year was 100%; at 2 years it was 93% +/- 6%, at 3 years 86% +/- 9%, at 5 years 79% +/- 11%, and at 10 years 50% +/- 15%. During follow-up, graft @entity715 occurred in three @entity1 . Of the @entity1 who underwent only a single SMA or celiac bypass, two of five died of @entity1188 ; only one of 16 @entity1 who underwent both celiac and SMA bypass had to undergo a repeat surgical procedure because of graft occlusion. Three of 16 retrograde bypasses thrombosed, compared with zero of five prograde bypasses. In nine @entity1 who underwent placement of mesenteric bypass grafts because of acute @entity63 caused by acute mesenteric @entity715 , the early mortality rate was 22%; the two deaths were the result of @entity63 . The cumulative survival rate was 78% +/- 14% at 1 month, 65% +/- 17% at 1 year, and 52% +/- 16% at 5 years. One of the two late deaths was due to graft @entity715 and @entity1188 . Three of four @entity1 who underwent concomitant mesenteric bypass at the time of @entity439 repair or aortobifemoral bypass survived the surgical procedure. CONCLUSIONS: When chronic and acute @entity5327 are diagnosed and treated with a bypass graft, the early and late results are good. Complete revascularization of the @entity6029 or both and prograde bypass may reduce the risk of late @entity63 .
