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Results of Open Mesenteric Reconstructions

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Mesenteric Vascular Disease

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Abstract

Our management of patients with CMI has evolved over the years. Currently over 70 % of the patients are treated with mesenteric angioplasty and stent placement. This option is preferred in the high-risk group and is also considered in low-risk patients with ideally suited lesions. Open mesenteric revascularization continues to have an important role in the endovascular era. Surgical bypass or, rarely, endarterectomy may be required because of unfavorable anatomy (flush or extensive occlusions, severe calcification, tandem lesions, small-sized vessels, or occluded stents) and younger patients with non-atherosclerotic lesions. Recent reports have shown that mesenteric bypass can be done safely in the hands of experienced surgeons with mortality rates that compare favorably to endovascular treatment. Open revascularization should focus on mesenteric artery revascularization as the primary goal and should avoid, if possible, extensive aortic or renal artery reconstruction. Anatomically, low-risk patients with flush or long-segment occlusions or stenosis, heavily calcified lesions, or atheromatous debris may be better suited for open repair. Young patients or women with small vessels may also be better candidates for open repair. Our preference in these patients has been a supra-celiac aorta to celiac and SMA bypass.

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Authors and Affiliations

  1. Division of Vascular and Endovascular Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA

    Thomas C. Bower MD

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  1. Thomas C. Bower MD
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Correspondence to Thomas C. Bower MD .

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Editors and Affiliations

  1. Division of Vascular and Endovascular Therapy, Mayo Clinic Gonda Vascular Center, Rochester, Minnesota, USA

    Gustavo S. Oderich

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Bower, T.C. (2015). Results of Open Mesenteric Reconstructions. In: Oderich, G. (eds) Mesenteric Vascular Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1847-8_12

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  • DOI: https://doi.org/10.1007/978-1-4939-1847-8_12

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1846-1

  • Online ISBN: 978-1-4939-1847-8

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