Antegrade revascularisation for chronic visceral ischaemia.

There is no consensus of opinion on the best surgical approach for the management of chronic visceral ischaemia. The antegrade revascularisation has several advantages. It provides an excellent exposure of the supraceliac aorta, the option of originating the bypass from several areas of the distal thoracic and supraceliac aorta that is usually spared of atherosclerosis and the bypass is placed in the direction of normal blood flow (antegrade direction). The supraceliac aorta can be approached through an abdominal or a low thoracoabdominal extraperitoneal route. The results on several series indicate that it is a durable and effective technique.