Superior Mesenteric Artery Thrombosis

 Acute mesenteric ischemia is a rare. It is characterized by a high mortality rate. This may be associated with a variety of congenital prothrombotic disorders. A prompt diagnosis is a prerequisite for successful treatment. The treatment of choice remains laparotomy and thrombo-endarterectomy, although some prefer an endovascular approach.
A second-look laparotomy could be required to evaluate viable intestinal handles. we support a laparoscopic second-look. The possibility of evaluating the arteriotomy, during a repeated laparotomy with a Doppler ultrasound, is crucial to show a new thrombosis. Although the prognosis of acute mesenteric ischemia due to an acute arterial mesenteric thrombosis remains poor, a prompt diagnosis, aggressive surgical treatment and supportive intensive care unit could improve the outcome for patients with this condition.

Femoro-femoral Cross over Graft in leg ischemia

Femoro-femoral cross over graft in leg ischemia

Patients develop critical limb ischemia due to multi segmental disease or one or two segmental steno-occlusive lesions. We are now considering Endovascular therapies (angioplasty and stenting) or hybrid procedures for revascualarization of the lower limbs. Long segmental occlusions, failed iliac stenting patients ( occlusion) are occassionally considered for femoro-femoral bypass which is very useful in them. There is always a concern about the chances of infection if there is an ulcer in the foot or toes with infected groin lymphatics. The need for this operation is certainly decreased over period of time.