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- W3084609671 abstract "The interesting paper by Xu et al. 1 Xu C. Tolaymat B. Taylor M. et al. Distal superior mesenteric artery endarterectomy remains an excellent option for mesenteric revascularization in the endovascular era. Ann Vasc Surg. 2020; https://doi.org/10.1016/j.avsg.2020.06.065 Abstract Full Text Full Text PDF Scopus (1) Google Scholar underlines the place of endarterectomy in superior mesenteric artery (SMA) surgery. About this, we consider interesting some patho-physiological observations. At first we remark the SMA characteristic of “feeding,” rather than of “conduit” artery. This agrees with its large network of ileal branches, consisting in numerous vascular arcades originating straight terminal vessels, and with its important role in the celiac–mesenteric arteries system, as proved by the efficient network of collaterals with the pancreato-duodenal arcades. Differently, the distal connections with the corresponding colonic vessels develop mainly, and sometimes only, through the ileocolic branch, itself one of its middle collaterals. Of note, its acute angle branching from the abdominal aorta is hemodynamically favorable in normal conditions, deriving its blood supply from the aortic stream, minimally changed in its vector direction; however, in case of arteriosclerotic parietal stiffening this anatomy can transform the physiological laminar blood flow into a turbulent and less efficient one, as a result of a high Reynolds number. Furthermore, in course of tachyarrhythmias, the SMA flow loses its pulsating waveform, becoming continuous and weaker, in agreement with an augmented Womersley number; this gets worse in case of sudden drop in splanchnic blood supply, because of increased resistances induced by a peripheral vasospasm. 2 Terlouw L.G. Moelker A. Abrahamsen J. et al. Mesenteric Ischemia Study group clinical guidelines on the diagnosis and treatment of patients with chronic mesenteric ischaemia. United Eur Gastroenterol J. 2020; 8: 371-395 Crossref PubMed Scopus (22) Google Scholar ,3 Gnanapandithan K. Feuerstadt P. Review article: Mesenteric ischemia. Curr Gastroenterol Rep. 2020; 22: 17 Crossref PubMed Scopus (14) Google Scholar" @default.
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- W3084609671 date "2021-01-01" @default.
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- W3084609671 title "Understanding Patho-physiology of the Superior Mesenteric Artery Endarterectomy" @default.
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- W3084609671 doi "https://doi.org/10.1016/j.avsg.2020.09.001" @default.
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