Successful Concomitant Revascularization in a Patient with Carotid, Coronary, and Intestinal Artery Occlusive Disease

2015 ◽  
Vol 18 (5) ◽  
pp. 219
Author(s):  
Ali Ihsan Parlar ◽  
Seyhan Babaroglu ◽  
Muhammet Onur Hanedan ◽  
Mehmet Ali Yürük ◽  
Salih Fehmi Katircioglu
Keyword(s):  
Coronary Artery Disease ◽  
Mesenteric Ischemia ◽  
Surgical Intervention ◽  
Mesenteric Arteries ◽  
Chronic Mesenteric Ischemia ◽  
Peripheral Arteries ◽  
Surgical Revascularization ◽  
Common Cause ◽  
Artery Disease

<strong>Background:</strong> Chronic mesenteric ischemia and carotid stenosis frequently have coexistent coronary artery disease. Myocardial ischemia is the most common cause of morbidity and mortality following revascularization of the peripheral arteries. The optimal treatment of concurrent mesenteric, carotid, and coronary disease is unknown. <br /><strong>Case Report:</strong> We report a case of a 75-year-old man who required revascularization of the left anterior descending coronary and superior mesenteric arteries and carotid endarterectomy. After concomitant surgical revascularization, the patient remained asymptomatic during the 3-year follow-up. <br /><strong>Conclusion:</strong> A good result in this case encourages us for one-stage combined surgical intervention in patients who require multisystem revascularization.

scholarly journals Mid-term outcomes of endovascular treatment for symptomatic chronic mesenteric ischemia

2011 ◽  
Vol 1 (1) ◽  
pp. 2 ◽  
Author(s):  
Eva Schönefeld ◽  
Susanne Szesny ◽  
Konstantinos P. Donas ◽  
Georgios A. Pitoulias ◽  
Giovanni Torsello
Keyword(s):  
Endovascular Treatment ◽  
Mesenteric Ischemia ◽  
Primary Patency ◽  
Mesenteric Arteries ◽  
Primary Study ◽  
Symptom Improvement ◽  
Initial Symptom ◽  
Secondary Patency ◽  
Chronic Mesenteric Ischemia

The authors would present the mid-term outcomes with the use of stent-supported angioplasty in the treatment of symptomatic chronic mesenteric ischemia (CMI). The present study is a retrospective analysis of 36 patients undergoing endovascular treatment of symptomatic CMI, between November 2000 and September 2009. Primary study endpoints were defined as primary patency, periprocedural and midterm mortality and complications, and symptom improvement after intervention. Forty-one mesenteric arteries (77.3% stenotic and 22.7% occluded vessels) were treated in 36 patients with 42 stents. In 30 patients (83.3%) one visceral artery and in 6 cases (16.7%) two visceral arteries were treated. Overall mortality was 16.7% (n=6) after a 60-month follow-up (mean follow-up period 30.1 months). Two early (&lt;30-day) deaths were caused by visceral ischemia (n=2: 5.5%). Late death was procedure-related in one patient with re-occlusion of the superior mesenteric artery after 12 months. The other 3 patients died from non procedure-related causes; e.g. twice myocardial infarction. Initial symptom relief was observed in 29 patients (80.5%); 7 patients reported no change. Primary patency was 83.3% after 5 years and secondary patency was 90.5% (38 out of 42 stents) among all patients. Two conversions to open surgery were documented. First-line endovascular approach of CMI is a reasonable strategy. Close follow-up is mandatory due to symptom recurrence and restenosis.

P4581Outcome of surgical revascularization for coronary artery disease after 30 years

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E M Delmo-Walter ◽  
R Hetzer
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ejection Fraction ◽  
Surgical Revascularization ◽  
Term Survival ◽  
Vein Grafts ◽  
Significant Difference ◽  
Artery Disease

Abstract Objective We report the long-term outcome of surgical revascularization in patients with coronary artery disease. Methods The institutional trial on Coronary Artery Disease and Surgical Therapy: Long-term Follow-up, is a 30-year follow-up study of 2728 patients with coronary artery disease who underwent surgical revascularization from April 1986 to December 1988. One-vessel coronary artery disease was found in 234 patients while 2 and 3-vessel diseases were found in 1021 and 1463 patients, respectively. Survival was analyzed according to age, gender, ejection fraction, and number of arterial and vein grafts (2165 males, mean age at coronary revascularization 59.4±8.8 years). Results Mean duration of follow-up was 30.6±1.2 years. Overall survival at this time point was 24.1%. Age–stratified survival was observed higher (40%) in those patients <50 years of age at that time of surgery compared to the other age groups, i.e. 50–59: 20%, 60–69: 10% and >70: 5% (p<0.001). Women had increased early mortality, hence have poorer survival (12%) than men (18%). However, when age (women=median 64.7, men=58.4, years) was considered between gender, no significant difference (p=0.13) in survival was observed. Interestingly, survival rate of patients with ejection fraction of <30% (n=826) was 6% which obviously fared well compared with 18% of those with ejection fraction of >30% (n=1902) at the time of coronary surgery. There was no significant difference between the use of a single internal mammary artery (IMA) [left or right] graft and use of 2 arterial grafts (combined left and right IMA or IMA and radial artery) on long-term survival (p=0.014). However, the use of an arterial graft combined with vein grafts are favorable (p<0.001). Conclusion The findings in this study showed that after a relatively long-term follow-up, age-based survival was similar compared to the general population. Female gender demonstrated poorer survival than men. However, when this is adjusted for age, no significant difference was shown. Interestingly, several patients with severely reduced ejection fraction, considered inoperable by many cardiac surgeons and cardiologists at the time of revascularization have survived for >30 years. Use of one internal mammary artery graft demonstrated better survival than use of only vein grafts. Noteworthy is that the sole use of vein grafts may also lead to an acceptable long-term survival.

scholarly journals Endovascular treatment of chronic mesenteric ischemia in an adolescent male: case report

F1000Research ◽  
2013 ◽  
Vol 2 ◽  
pp. 277
Author(s):  
Sadiq Muhammed Al-Hammash ◽  
Abd El-Salam Dawood Al-Ethawi ◽  
Kasim Abbas Ismail
Keyword(s):  
Mesenteric Ischemia ◽  
The Elderly ◽  
Mesenteric Arteries ◽  
Adolescent Male ◽  
Chronic Mesenteric Ischemia ◽  
Bowel Infarction ◽  
Common Cause ◽  
Percutaneous Balloon ◽  
Percutaneous Balloon Angioplasty ◽  
Children And Young Adults

Chronic mesenteric ischemia (CMI) is a condition characterized by inadequate blood flow to the bowel resulting from stenosis of one or more of the three mesenteric arteries. Fibromuscular dysplasia is the most common cause in children and young adults; whereas atherosclerosis is the most common cause in the elderly. Treatment is mandatory in symptomatic patients, because it may lead to malnutrition, bowel infarction or even death.Herein, we present the case of a 14-year old male, diagnosed with CMI who underwent percutaneous balloon angioplasty (PTA) followed by stent placement with immediate positive results.

Chronic Mesenteric Ischemia: Clinical Diagnosis, Imaging Characteristics, and Endovascular Management

2018 ◽  
Vol 02 (03) ◽  
pp. 217-222
Author(s):  
Leonard Dalag ◽  
Jonathan Lorenz ◽  
Thomas Tullius
Keyword(s):  
Mesenteric Ischemia ◽  
Mesenteric Arteries ◽  
Definitive Treatment ◽  
Clinical Approach ◽  
Chronic Mesenteric Ischemia ◽  
Endovascular Management ◽  
Surgical Revascularization ◽  
Mesenteric Vessel ◽  
Imaging Characteristics ◽  
Multiple Imaging

AbstractChronic mesenteric ischemia (CMI) is a complex disorder, which typically affects elderly patients who classically present with longstanding abdominal pain and nonspecific clinical symptoms, such as food aversion and weight loss. The disease progression is often gradual due to a rich collateral network, and symptoms are generally not clinically apparent until two or more primary visceral arteries are affected. Symptomatic stenosis or occlusion of the mesenteric arteries can be the result of multiple etiologies, although atherosclerosis is the most common. Given its low incidence, a high clinical suspicion is necessary for diagnosis and to prevent a delay in treatment. Multiple imaging modalities are utilized to confirm the presence of mesenteric vessel involvement and to guide treatment. While open surgical revascularization was once the definitive treatment, endovascular management has become the first-line treatment for atherosclerotic CMI. The endovascular approach with stent placement has shown excellent primary success and encouraging long-term outcomes with reduction in morbidity and mortality compared with open surgical revascularization. Although controversial, median arcuate ligament syndrome (MALS) is a less common cause of CMI, which can affect a more varied patient population. Clinical approach, imaging characteristics, and treatment for this syndrome will also be discussed.

Serum FGF-21 Is Associated with Future Cardiovascular Events in Patients with Coronary Artery Disease—Results from a Median Follow-Up of 4.8 Years Study

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 426-P
Author(s):  
YUQIAN BAO ◽  
YUN SHEN ◽  
XUELI ZHANG ◽  
YITING XU ◽  
QIN XIONG ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiovascular Events ◽  
Artery Disease

scholarly journals Impact of comprehensive management on clinical outcomes in hypertensive patients with coronary artery disease: HIJ-CREATE sub-study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Ogawa ◽  
H Sekiguchi ◽  
K Jujo ◽  
E Kawada-Watanabe ◽  
H Arashi ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Primary Outcome ◽  
Ldl Cholesterol ◽  
Lipid Lowering ◽  
Hypertensive Patients ◽  
Mean Values ◽  
Comprehensive Management ◽  
The Mean ◽  
Artery Disease

Abstract Background There are limited data on the effects of blood pressure (BP) control and lipid lowering in secondary prevention of coronary artery disease (CAD) patients. We report a secondary analysis of the effects of BP control and lipid management in participants of the HIJ-CREATE, a prospective randomized trial. Methods HIJ-CREATE was a multicenter, prospective, randomized, controlled trial that compared the effects of candesartan-based therapy with those of non-ARB-based standard therapy on major adverse cardiac events (MACE; a composite of cardiovascular death, non-fatal myocardial infarction, unstable angina, heart failure, stroke, and other cardiovascular events requiring hospitalization) in 2,049 hypertensive patients with angiographically documented CAD. In both groups, titration of antihypertensive agents was performed to reach the target BP of &lt;130/85 mmHg. The primary endpoint was the time to first MACE. Incidence of endpoint events in addition to biochemistry tests and office BP was determined during the scheduled 6, 12, 24, 36, 48, and 60-month visits. Achieved systolic BP and LDL-Cholesterol (LDL-C) level were defined as the mean values of these measurements in patients who did not develop MACEs and as the mean values of them prior to MACEs in those who developed MACEs during follow-up. Results During a median follow-up of 4.2 years (follow-up rate of 99.6%), the primary outcome occurred in 304 patients (30.3%). Among HIJ-CREATE participants, 905 (44.2%) were prescribed statins on enrollment. Kaplan–Meier curves for the primary outcome revealed that there was no relationship between statin therapy and MACEs in hypertensive patients with CAD. The original HIJ-CREATE population was divided into 9 groups based on equal tertiles based on mean achieved BP and LDL-C during follow-up. For the analysis of subgroups, estimates of relative risk and the associated 95% CIs were generated with a Cox proportional-hazards model (Figure 1). The relation between LDL cholesterol level and hazard ratios for MACEs was nonlinear, with a significant increase of MACEs only in the patients with inadequate controlled LDL-C level even in the patients with tightly controlled BP. Conclusions The results of the post-hoc analysis of the HIJ-CREATE suggest that clinicians should pay careful attention to conduct comprehensive management of lipid lowering even in the contemporary BP lowering for the secondary prevention in hypertensive patients with CAD. Figure 1 Funding Acknowledgement Type of funding source: None

Long-Term Follow-Up of Patients With Isolated Side Branch Coronary Artery Disease

Angiology ◽  
2021 ◽  
pp. 000331972110280
Author(s):  
Sukru Arslan ◽  
Ahmet Yildiz ◽  
Okay Abaci ◽  
Urfan Jafarov ◽  
Servet Batit ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Vessel Diameter ◽  
Side Branch ◽  
Clinical Risk Factors ◽  
Clinical Risk ◽  
Artery Disease

The data with respect to stable coronary artery disease (SCAD) are mainly confined to main vessel disease. However, there is a lack of information and long-term outcomes regarding isolated side branch disease. This study aimed to evaluate long-term major adverse cardiac and cerebrovascular events (MACCEs) in patients with isolated side branch coronary artery disease (CAD). A total of 437 patients with isolated side branch SCAD were included. After a median follow-up of 38 months, the overall MACCE and all-cause mortality rates were 14.6% and 5.9%, respectively. Among angiographic features, 68.2% of patients had diagonal artery and 82.2% had ostial lesions. In 28.8% of patients, the vessel diameter was ≥2.75 mm. According to the American College of Cardiology lesion classification, 84.2% of patients had either class B or C lesions. Age, ostial lesions, glycated hemoglobin A1c, and neutrophil levels were independent predictors of MACCE. On the other hand, side branch location, vessel diameter, and lesion complexity did not affect outcomes. Clinical risk factors seem to have a greater impact on MACCE rather than lesion morphology. Therefore, the treatment of clinical risk factors is of paramount importance in these patients.

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