Management of Chronic Gastrointestinal Ischemia
Year: 2012
Type: dissertation
Abstract: Gastrointestinal ischemia results from a mismatch of blood supply to the main gastrointestinal\narteries and the oxygen demand to maintain adequate metabolism. Three aortic\nbranches supply blood to the gastrointestinal tract: the celiac artery, the superior mesenteric\nartery, and the inferior mesenteric artery. One of the main causes of chronic gastrointestinal\nischemia (CGI) is stenotic or occlusive disease of the supplying gastrointestinal arteries. For\na long time it was thought that only occlusive disease of two or more gastrointestinal arteries\ncould lead to CGI. The introduction of functional testing has played a pivotal role in the\ndiagnosis of CGI. Functional testing has shown that CGI is more common than previously\nthought because it can also be caused by single vessel disease. Further studies showed that\na majority of patients with single vessel disease had sustained response after adequate treatment.\nMoreover, functional testing seems to be pivotal to select patients who will benefit\nfrom treatment, whether the cause is single- or multi-vessel disease.\nIn this thesis we aimed to study different aspects of diagnosis and treatment of CGI. We\nstudied the predictive value of functional testing in diagnosis of CGI, and determined the\ndiagnostic accuracy of a new minimally invasive technique to detect ischemia in order to\noptimize the diagnosis of CGI. Furthermore, we assessed the risk factors for atherosclerotic\ndisease of the abdominal arteries, being one of the main causes of CGI. We also evaluated\nthe clinical success of revascularization in single vessel disease and response to vasodilation\ntherapy in patients with non-occlusive CGI.
Author: Aria Sana
Language: Slovenian
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1797449061