engleski

Chronic visceral ischemia - our experience in surgical treatment of complex cases

Aim. The first treatment option for symptomatic chronic mesenteric ischemia nowadays is usually endovascular, as it is associated with lower morbidity and mortality. There are situations, however, in which open surgery is better option, as it has better long-term results, especially in fit patients. The results of surgical treatment may be hindered by relative infrequency of these procedures, as well as the preference for endovascular treatment in recent times, leaving the most complex cases for open surgery. The aim of this case series is to review the results of the surgical treatment of patients with chronic mesenteric ischemia in our institution in 2021. Methods. A retrospective analysis of medical histories of patients treated surgically for chronic mesenteric ischemia at the Clinical Hospital Center Zagreb in 2021 was performed. Results. Medical records of two patients with chronic mesenteric ischemia treated surgically in our institution in 2021. were retrieved. One of the patients had severe stenosis of celiac axis and superior mesenteric artery, with associated thrombosis, and was treated by a thrombectomy and a retrograde iliacomesenteric bypass. The other patient had an occlusion of celiac axis and both superior and inferior mesenteric arteries, and was treated by a bypass from the aorta to celiac axis and the superior mesenteric artery. Both patients recovered and were released from the hospital. Conclusion. The choice of intervention for treatment of chronic mesenteric ischemia depends on the nature and extent of lesions, and the fitness of the patient for surgery. Open surgery is usually the preferred option in complex cases, usually in patients with extensive and heavily calcified lesions involving several visceral arteries. Early results in patients recently operated in our institution substantiate this view. Further studies will be performed in order to compare early and long-term results of endovascular, hybrid and open surgical treatment.

chronic mesenteric ischemia ; open surgery ; endovascular ; hybrid treatment intervention

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