The internal iliac arteries do not supply the infe

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Publish Date: 1998/03

Volume: 7, Issue: 02, Pages: 165-168

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Abstract

Ischemic colitis can be prevented after surgical treatment for abdominal aortic aneurysm by routine or elective reconstruction of the inferior mesenteric artery IMA when this vessel is patent Revascularization of at least one internal iliac artery IIA has been recommended when the IMA is occluded although the validity of such reconstruction has never been substantiated This study investigated the role of the IIAs in IMA hemodynamics Do IIAs contribute significant collateral blood supply to the IMA bed in the treatment of abdominal aortic aneurysms Between July 1990 and June 1992 100 patients underwent elective aneurysmectomy At least one IIA was routinely reconstructed whenever possible 24 patients had 27 IIA revascularizations When the IMA was patent 49 cases the residual pressure in the inferior mesenteric artery IMA stump pressure and the pressure in the radial artery were measured before and during temporary occlusion of the IIAs The inferior mesenteric indices P defined by the ratio of the IMA stump pressure PIMA to the pressure in the radial artery PRAD were calculated before P1 and during P2 clamping of the IIAs The mean value of P1 was 064 ± 003 versus 063 ± 003 for P2 P=NS Adjustment of variations in P1 as a function of P2 by linear regression gave a straight line with a slope of less than 1 The IMA stump pressure is independent of whether vascular continuity of the IIAs is restored or whether these vessels are excluded The IIAs do not contribute significant collateral blood supply to the IMA bed in treatment of abdominal aortic aneurysms

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