Problem: A 70-year-old man was planned for open AAA repair at the University of California Medical Center at Davis, CA. A previous aorto-bifemoral bypass, performed over 20 years ago, was placed too low. Now, there was an aneurysm and a large IMA. Whether it would be safe to cover the IMA or not was unclear and controversial -- both hypogastric arteries were chronically occluded. At Surgical Rounds, some suggested to operate and re-implant IMA, others suggested a stent graft, but only if there is a way for it to be safe.

Solution: An angiogram was performed assisted by T-Stat. A balloon occlusion of the IMA was performed with the rectal probe in place -- with no change in the colon saturation. Based upon this, a stent graft was performed, again with T-Stat in place, with no change in colon saturation. The patient did well after stent graft, avoiding major surgery.

Case 3: Detecting Colon Ischemia in the ICU

Problem: "Usually it is difficult for the attending M.D. to detect colonic ischemia, even when he is standing at the bedside--colonic ischemia is an extremely difficult thing to detect by physical exam. So this device is absolutely of critical significance. "Just imagine a huge belly wound and how painful that is in the ICU, then imagine trying to differentiate colonic ischemic pain in the SAME AREA underneath the wound with a patient in too much pain to fully cooperate (or intubated)".

Solution: T-Stat was performed in the ICU in a patient at the VA Medical Center in Palo Alto, CA, determining the presence of colon ischemia within minutes. The device can be left in place throughout the hospitalization in patients at risk for colon ischemia.