BACKGROUND: Chronic mesenteric ischemia can be difficult to diagnose by means of currently available clinical techniques. We developed a novel endoscopic device for objective measurement of GI mucosal ischemia. OBJECTIVE: Our purpose was to evaluate the performance of the device in patients with chronic mesenteric ischemia. DESIGN: A fiberoptic catheter-based visible light spectroscopy oximeter (T-Stat 303 Microvascular Oximeter, Spectros, Portola Valley, Calif) was used to evaluate 30 healthy control subjects and 3 patients with chronic mesenteric ischemia before and after successful percutaneous stenting. SETTING: Veterans Affairs Palo Alto Health Care System hospital. RESULTS: Normal mucosal (capillary) hemoglobin oxygen saturation was 60% to 73% in the duodenum and jejunum. In the 3 patients with chronic mesenteric ischemia, ischemic areas in the duodenum or proximal jejunum were found with mucosal saturations of 16% to 30%. After successful angioplasty and stent placement of the celiac, superior mesenteric, or inferior mesenteric arteries, the mucosal saturation in these areas increased to 51% to 60%. CONCLUSIONS: This preliminary study suggests that chronic mesenteric ischemia is detectable during endoscopy by use of visible light spectroscopy and that successful endovascular treatment results in near normalization of mucosal oxygen saturation.
BACKGROUND: Chronic mesenteric ischemia can be difficult to diagnose by means of currently available clinical techniques. We developed a novel endoscopic device for objective measurement of GI mucosal ischemia. OBJECTIVE: Our purpose was to evaluate the performance of the device in patients with chronic mesenteric ischemia. DESIGN: A fiberoptic catheter-based visible light spectroscopy oximeter (T-Stat 303 Microvascular Oximeter, Spectros, Portola Valley, Calif) was used to evaluate 30 healthy control subjects and 3 patients with chronic mesenteric ischemia before and after successful percutaneous stenting. SETTING: Veterans Affairs Palo Alto Health Care System hospital. RESULTS: Normal mucosal (capillary) hemoglobin oxygen saturation was 60% to 73% in the duodenum and jejunum. In the 3 patients with chronic mesenteric ischemia, ischemic areas in the duodenum or proximal jejunum were found with mucosal saturations of 16% to 30%. After successful angioplasty and stent placement of the celiac, superior mesenteric, or inferior mesenteric arteries, the mucosal saturation in these areas increased to 51% to 60%. CONCLUSIONS: This preliminary study suggests that chronic mesenteric ischemia is detectable during endoscopy by use of visible light spectroscopy and that successful endovascular treatment results in near normalization of mucosal oxygen saturation.
Authors: Piotr Paluszkiewicz; Wojciech Dudek; Najib Daulatzai; Andrzej Stanislawek; Colin Hart Journal: World J Surg Date: 2010-04 Impact factor: 3.352