Mehmet ÖZÜLKÜ, Erdal KARAGÜLLE, Özgür ÇİFTÇİ, Murat GÜNDAY, Erkan YILDIRIM

Endovascular treatment of recurrent mesenteric ischemia after aortomesenteric bypass

A 71-year-old male patient was admitted to our clinic with abdominal pain, anorexia, nausea, vomiting and weight loss. Physical examination revealed abdominal tenderness and rebound with hypoactive bowel sounds. Abdominal computed tomography showed that the origin of the superior mesenteric artery and proximal was occluded at a 2-cm segment level. The patient underwent surgery due to the presence of acute abdominal findings and the judgment of the interventional radiologist regarding the unability to open the occlusion angiographically. It was bypassed between superior mesenteric artery and infrarenal aorta with a saphenous vein. Abdominal computed tomography was repeated at one month due to the recurrence of the patient complaints. Angiography was performed due to saphenous graft occlusion in tomography scan. A stent was placed in inferior mesenteric artery with the guide of angiography. The patient is normal except for vague abdominal pain in the first month of the procedure.

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1. Hansen KJ, Wilson DB, Craven TE, Pearce JD, English WP, Edwards MS, et al. Mesenteric artery disease in the elderly. J Vasc Surg 2004;40:45-52.
2. Chang JB, Stein TA. Mesenteric ischemia: acute and chronic. Ann Vasc Surg 2003;17:323-8.
3. Emrecan B, Önem G, Baltalarlı A. İntestinal anjina: Karın ağrısının ender bir nedeni. Turk Gogus Kalp Dama 2008;16:269-73.
4. Cleveland TJ, Nawaz S, Gaines PA. Mesenteric arterial ischaemia: diagnosis and therapeutic options. Vasc Med 2002;7:311-21.
5. Zwolak RM. Can duplex ultrasound replace arteriography in screening for mesenteric ischemia? Semin Vasc Surg 1999;12:252-60.
6. Oderich GS, Bower TC, Sullivan TM, Bjarnason H, Cha S, Gloviczki P. Open versus endovascular revascularization for chronic mesenteric ischemia: risk-stratified outcomes. J Vasc Surg 2009;49:1472-9.e3.
7. Park WM, Cherry KJ Jr, Chua HK, Clark RC, Jenkins G, Harmsen WS, et al. Current results of open revascularization for chronic mesenteric ischemia: a standard for comparison. J Vasc Surg 2002;35:853-9.
8. Zelenock GB, Graham LM, Whitehouse WM Jr, Erlandson EE, Kraft RO, Lindenauer SM, et al. Splanchnic arteriosclerotic disease and intestinal angina. Arch Surg 1980;115:497-501.
9. Mateo RB, O’Hara PJ, Hertzer NR, Mascha EJ, Beven EG, Krajewski LP. Elective surgical treatment of symptomatic chronic mesenteric occlusive disease: early results and late outcomes. J Vasc Surg 1999;29:821-31.
10. McMillan WD, McCarthy WJ, Bresticker MR, Pearce WH, Schneider JR, Golan JF, et al. Mesenteric artery bypass: objective patency determination. J Vasc Surg 1995;21:729-40.