ABSTRACT
Chronic mesenteric ischemia (CMI) is mostly the result of atherosclerotic occlusive processes of unpaired mesenteric arteries. Operative procedures are preferred in cases of occlusion of a long vessel segments and/or highly calcified stenoses near the ostium. Frequently, bypasses are constucted from the aorta to visceral arteries and autologous veins should be preferred. Due to atherosclerotic alterations aortic bypass anastomoses are difficult and prone to complications. Based on case descriptions a surgical technique is presented that simplifies the aortovisceral artery bypass procedure. In all 6 patients the bypasses were open after 27 months and the average increase in body weight was 13â¯kg within the first postoperative 6 months.
Subject(s)
Mesenteric Ischemia , Mesenteric Vascular Occlusion , Vascular Surgical Procedures , Aorta , Chronic Disease , Humans , Ischemia , Mesenteric Arteries , Mesenteric Artery, Superior , Mesenteric Ischemia/surgery , Treatment OutcomeSubject(s)
Thoracic Outlet Syndrome/etiology , Venous Thrombosis/diagnostic imaging , Adult , Causality , Constriction, Pathologic/diagnostic imaging , Female , Fibrin Fibrinogen Degradation Products/metabolism , Humans , Phlebography , Risk Factors , Subclavian Vein/diagnostic imaging , Subclavian Vein/surgery , Thoracic Outlet Syndrome/blood , Thoracic Outlet Syndrome/diagnostic imaging , Thoracic Outlet Syndrome/therapy , Thrombolytic Therapy , Ultrasonography, Doppler, Color , Venous Thrombosis/blood , Venous Thrombosis/therapyABSTRACT
We report on the case of a 45-year-old man with stroke and progressive neurological symptoms. Duplex sonography showed an occlusion of the left common carotid artery as well as an open internal carotid artery due to retrograde flow from the external carotid artery into the internal carotid artery with pseudovenous flow. Transcranial duplex sonography showed a pseudovenous flow in the ipsilateral middle cerebral artery, because of insufficient intracranial collateralisation. During operative revascularisation, a primary shunt from the aortic arch to the internal carotid artery was necessary. After revascularisation, perfusion of the left middle cerebral artery was normal and the neurological symptoms abated. Revascularisation of a common carotid artery occlusion in case of progressive stroke may be indicated. The central position of the shunt and the surgical procedure described provide sufficient cerebral perfusion.
