CHRONIC VISCERAL ISCHEMIA - SURGICAL-TREATMENT IN MULTIPLE VESSEL OCCLUSION

A 57-year-old patient with general arteriosclerosis and end-stage rena l failure was found to be suffering from occlusion of the mesenteric a rteries. The symptoms were rapidly progressive. The aortogram showed t hat nutrition of the whole intestine took place via a collateral vesse l that originated at both internal iliac arteries. Revascularization o f the superior mesenteric artery with interposition of Gore-Tex prosth esis and transposition to the aorta were performed. The postoperative course was uncomplicated, but prolonged due to the accompanying diseas es. In conclusion, single-vessel revascularization for chronic intesti nal ischemia is a safe and sufficient procedure. Interpositioning of a graft and transposition to the aorta have the advantages of infrarena l access with an antegrade blood flow and no kinking of the prosthesis .