Techniques of Open Mesenteric Reconstructions

Abstract

Over the past decade, endovascular therapy has changed the role for open reconstructions to treat atherosclerotic mesenteric artery stenoses. While initially reserved for high-risk patients, endovascular therapy is now routinely used at most institutions to treat all patients with favorable lesions. However, there still is a role for open surgery. Patients with flush occlusions, thick calcified lesions, those with long stenoses, and individuals who have failed angioplasty and stenting are best served with an open operation. Herein, the surgical exposures and techniques of antegrade and retrograde reconstructions will be reviewed.