Australia & New Zealand Society of Vascular Surgeons

Objectives Chronic splanchnic syndrom (CSS) is defined as symptomatic single or multi vessel obliterative splanchnic vascular disease. We analyzed the endovascular treatment of CSS. Patients and Methods 278 consecutive patients with the suspicion of CSS, in the period of July 1996 – December 2002, were analyzed. Based on the medical history, together with duplex and exercise gastric tonometry, the hypothesis of CSS was confirmed in 97 patients. Twenty seven of these patients were treated endovascular (mean age 59 yrs, range 28-81 yrs, 13 ♀, one 3-vessel, twelve 2-vessel, fourteen 1-vessel CSS). Four patients received earlier endovascular treatment of CSS. Severe cardiac and/or pulmonary co-morbidity or cachexia was observed in 23 patients (85%). Endovascular treatment consisted of solitary PTA of the CA or the SMA in 2 and PTA-stent (Bridge® Medtronic-AVE) in 25 patient (12 CA and 9 SMA solitary and 4 CA and SMA both). Results Relevant procedural complications were observed in 3 patients. Mean follow-up was 19 months (range of 2-76 months). Five patients underwent a re-intervention (19%; 4 redo-PTA, 1 antegrade two vessel venous bypass). Improvement or recovery of the CSS was observed in 22 pts (81%). Two patients died, both not CSS related. Five patients claimed no improvement without evidence of re-stenosis. Conclusion The endovascular treatment of CSS has a fairly reasonable outcome and is as such an alternative for operative treatment, especially for those patients with a high co-morbidity or a short life expectancy.