OBJECTIVE: Questions remain concerning the optimal site of graft origin and the extent of revascularization necessary to achieve excellent results for chronic @entity5327 (CMI). Endovascular therapy also is performed for CMI. These factors prompted us to review our results to provide a current standard. METHODS: Ninety-eight @entity1 who underwent operation for CMI from 1989 to 1998 were reviewed. @entity1 with @entity63 and arcuate ligament syndrome were excluded. RESULTS: Seventy-six @entity1 (78%) and 22 @entity1 (22%), with an average age of 66 years (range, 36 to 87 years), participated in the study. @entity490 was present in 95 @entity1 (97%), and @entity353 in 92 @entity1 (94%). The superior mesenteric artery was severely diseased (70% to 99% @entity850 or occlusion) in 90 @entity1 (92%), the celiac artery in 81 @entity1 (83%), and both arteries in 76 @entity1 (78%). Bypass grafts were performed in 91 @entity1 (93%), 77 antegrade and 14 retrograde. Of the other seven @entity1 , five had endarterectomies, one reimplantation, and one patch angioplasty. Multivessel reconstruction was performed in 79 @entity1 (81%), and single-vessel reconstruction in 19 (19%). Twelve @entity1 had concomitant aortic reconstruction. Three early graft @entity715 were seen. Five hospital deaths occurred (5.1%); one case had concomitant aortic reconstruction (1/12 versus 4/86; P = not significant). All five @entity1 who died were older than 70 years (5/41 versus 0/57; P =.011). The median follow-up period was 1.9 years (range, 0 to 9.6 years). Follow-up was complete in all survivors. The 1-year, 5-year, and 8-year survival rates were 83%, 63%, and 55%, respectively. These rates were worse than the rates of the age-matched/gender-matched control subjects (P <.001). Survival was worse in @entity1 greater than 70 years of age (P =.0013). Survival was unaffected by the number of vessels revascularized. The @entity1 with retrograde grafts had decreased median survival rates (4.0 versus 5.7 years; P =.026), but they were older (75 versus 65 years; P =.0013). The 1-year and 5-year symptom-free survival rates were 95% and 92%, respectively. Symptoms recurred in six @entity1 (6%): four had recurrent @entity850 /occlusion and two had patent grafts. Symptom-free survival was unaffected by the number of vessels revascularized or by graft orientation. CONCLUSION: Operation for CMI was successful for most @entity1 , with low operative mortality and excellent long-term relief of symptoms. Selective concomitant aortic procedures did not increase mortality rates. The rate of symptomatic recurrences was not different for single-vessel versus multiple-vessel reconstructions or for antegrade versus retrograde grafts. @entity1 older than 70 years had increased operative mortality and decreased survival rates. Endovascular therapy may be appropriate for this subset of @entity1 .

Current results of open revascularization for chronic XXXX : a standard for comparison.

@entity1 :: ('9606', 'Species') :: ['men', 'women', 'Patients', 'patients'] @entity353 :: ('MESH:D015431', 'Disease') :: ['weight loss'] @entity63 :: ('MESH:D007511', 'Disease') :: ['acute ischemia'] @entity490 :: ('MESH:D015746', 'Disease') :: ['Abdominal pain'] @entity715 :: ('MESH:D013927', 'Disease') :: ['thromboses'] @entity850 :: ('MESH:D003251', 'Disease') :: ['stenosis'] @entity5327 :: ('MESH:D065666', 'Disease') :: ['mesenteric ischemia']
@entity5327 :: (MESH:D065666,Disease) :: ['mesenteric ischemia']
