INTRODUCTION: @entity5327 ( @entity5327 ) caused by @entity432 requires prompt diagnosis and revascularization to avoid the high mortality associated with this disease. In an attempt to minimize the magnitude of operation for arterial occlusive @entity5327 , we have developed a new technique of endovascular recanalization and open retrograde stenting of the @entity6029 ( @entity6029 ) during laparotomy so that the bowel can also be assessed and resected if necessary. METHODS: All emergent mesenteric revascularizations for arterial occlusive @entity5327 performed at Dartmouth-Hitchcock Medical Center from 2001 to 2005 (n = 13) were retrospectively reviewed. Outcomes were analyzed with respect to the method of revascularization and other perioperative variables. @entity256 was evaluated with duplex ultrasound imaging. RESULTS: Three different revascularization methods were used: surgical bypass (n = 5), antegrade percutaneous stenting (n = 2), and retrograde open mesenteric ( @entity6029 ) stenting (ROMS, n = 6). Satisfactory revascularization was achieved in all cases and all methods. ROMS was successfully accomplished in three of six @entity1 after antegrade attempts to cross the @entity6029 from the arm were unsuccessful. At 17%, the ROMS group had the lowest hospital mortality compared with bypass at 80% (P = .08) and percutaneous stent at 100% (P = .11). All five of the surviving @entity1 treated with ROMS were discharged to home after a mean hospital stay of 20 days (range, 6 to 38 days). During a mean follow-up of 13 +/- 7 months, three @entity1 died of unrelated causes, of which two were being followed with asymptomatic recurrent @entity6029 detected by duplex scan. The two surviving @entity1 are alive and well, but one has required percutaneous @entity6029 stenting of a progressive asymptomatic restenosis. CONCLUSION: Retrograde open @entity6029 stenting during laparotomy for @entity5327 has a high technical success rate and provides an attractive alternative to surgical bypass in these often critically ill @entity1 . Because it is combined with open laparotomy, it honors the essential surgical principles of evaluating and resecting nonviable bowel. @entity256 rates appear to be high, so that @entity1 must be followed closely. Further study and development of this new hybrid technique is warranted.

Retrograde mesenteric stenting during laparotomy for XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity256 :: ('MESH:D023903', 'Disease') :: ['Restenosis'] @entity6029 :: ('MESH:D013478', 'Disease') :: ['SMA stenosis', 'superior mesenteric artery', 'SMA'] @entity432 :: ('MESH:D001157', 'Disease') :: ['arterial occlusive disease'] @entity5327 :: ('MESH:D065666', 'Disease') :: ['Acute mesenteric ischemia', 'AMI']
@entity5327 :: (MESH:D065666,Disease) :: ['acute occlusive mesenteric ischemia']
