Hepatic Salvage with Renosplenic Arterial Bypass

Abstract

Extraanatomic vascular bypasses are useful in treating renal and visceral occlusive disease. The splenic artery can be a good conduit in such cases and splenorenal bypass is a well-appreciated technique for treating renovascular obstructions. If there is severe ostial celiac stenosis or occlusion, then this particular anastomosis (splenic to renal) actually revascularizes the foregut via retrograde flow in the splenic artery Although this method of celiac axis reperfusion has not been previously described, it was successfully employed recently in a situation where severe hepatic ischemia persisted following superior mesenteric artery embolectomy The reasons for residual ischemia following visceral embolectomy are discussed as well as the alternative methods for extraanatomic intraabdominal vascular reconstruction.