Revascularization Methods in Chronic Intestinal Ischemia—Case Studies

Abstract

Chronic intestinal ischemia is an uncommon disease clinically, usually due to advanced atherosclerotic stenosis or occlusion of the intestinal arteries without adequate collateral blood flow to the intestine.

Standard aortography with lateral views remains the definitive diagnostic procedure. Revascularization by bypass to the celiac artery for one of its branches and the superior mesenteric artery with dacron graft is recommended to avoid infarction of the bowel and its catastrophic consequences.

Six patients with chronic intestinal ischemia underwent successful revascu larization. All six intestinal artery bypasses were performed by use of knitted dacron grafts and/or autogenous vein grafts. There were no postoperative com plications or deaths. One patient has subsequently died, fourteen months after discharge, from a massive hemorrhage due to an aortoduodenal fistula. The 5 patients who were still alive are gaining weight, and none has required reopera tion for an occluded graft or has developed bowel necrosis.