Acute mesenteric ischemia

Cortese, Bernardo; Limbruno, Ugo

doi:10.1002/ccd.22261

Cited by 20 publications

(4 citation statements)

References 3 publications

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“…In six patients, supplemental laparotomy was carried out because sufficient revascularization of the entire bowel was not achieved, or abdominal symptoms persisted, became worse, or recurred [24]. Though this and other studies show that primary percutaneous revascularization is feasible with promising mortality rates, this is not yet a routine treatment [25][26][27]. To note, angiography is incapable to diagnose or exclude bowel infarction, and the attempt of primary percutaneous revascularization might go along with loss of valuable time.…”

Section: Mesenteric Arterial Embolismmentioning

confidence: 86%

Intestinal ischemia: current treatment concepts

Renner

Kienle

Dahlke

et al. 2010

Langenbecks Arch Surg

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Patients with acute mesenteric ischemia are still at highest risk for a fatal course of disease. New diagnostic and therapeutic developments have not been tested in larger studies yet, neither has any of these methods led to an increased survival in studies published so far. Taken together, mesenteric ischemia requires high awareness, earliest possible diagnosis, and treatment by an experienced interdisciplinary team of gastroenterologists, radiologists, and surgeons.

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Section: Mesenteric Arterial Embolismmentioning

confidence: 86%

Intestinal ischemia: current treatment concepts

Renner

Kienle

Dahlke

et al. 2010

Langenbecks Arch Surg

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“…Given the low incidence of ATOS, it is challenging for any treatment center to provide feedback on ATOS cases within a relatively short period. There have been a few related studies reporting small sample sizes [ 8 – 12 , 19 , 20 ]. However, whether or not interventional therapy should be the primary treatment for ATOS is still controversial [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Endovascular Treatment for Acute Thromboembolic Occlusion of the Superior Mesenteric Artery and the Outcome Comparison between Endovascular and Open Surgical Treatments: A Retrospective Study

Zhang

Wang

Li³

et al. 2017

BioMed Research International

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We reported our experience with endovascular treatment for patients with acute thromboembolic occlusion of the superior mesenteric artery (ATOS) as well as comparing the efficacy between endovascular and traditional open surgical treatments. Eighteen consecutive patients with ATOS who received endovascular treatment and 12 patients who received open surgical treatment between February 2007 and October 2012 at Tianjin Union Medical Center (Tianjin, China) were retrospectively reviewed. Primary clinical outcomes included the technical success, requirement of laparotomy, length of bowel resection, perioperative mortality within 30 days, and surgical complications. The patients were followed up for 0.1 to 98 months. For patients who underwent endovascular treatment, complete technical success was achieved in 8 (44.4%) patients and partial success was achieved in the remaining 10 (55.6%) patients. Laparotomy was required in 6 (33.3%) patients. The 30-day mortality was 16.7%. In comparison to open surgical therapy, endovascular therapy achieved lower requirement of laparotomy (in 33.3% versus in 58.3% of cases, p = 0.18), significantly shorter average length of bowel resection (88 ± 44 versus 253 ± 103 cm, p = 0.01), and lower mortality rate (16.7% versus 33.3%, p = 0.68). The endovascular therapy is a promising treatment alternative for ATOS.

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“…Thrombolytic therapy is an effective and quick treatment modality for AMI and may obviate surgery and has the potential to resolve the clot completely [15,16]. If resolution occurs partially, it already serves as an adjunctive to surgery by sparing an amount of near-ischemic bowel segments [6,7].…”

Section: Discussionmentioning

confidence: 99%

Local thrombolytic therapy in acute mesenteric ischemia

et al. 2013

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BackgroundThe aim of the study was to evaluate the local thrombolytic therapy (LTT) in combination with laparoscopy, in management of acute mesenteric ischemia (AMI).MethodsFrom January 2000 to January 2010, patients who were admitted to the hospital with AMI due to acute arterial occlusion were analysed retrospectively. Patients presenting with acute abdomen with a suspicion of AMI were evaluated with computerized tomography angiography (CTA). Patients who had findigs of AMI on CTA, were underwent selective mesenteric angiography and LTT eventhough without peritoneal signs. LTT was carried out before or after laparoscopy or laparotomy, and initiated with recombinant plasminogen activator.ResultsLTT was performed in 13 (17.1%), out of 76 patients. From the remaining patients, 56 underwent necrotic bowel resection and 7 underwent tromboembolectomy. The median age was 62 years (45–87). The median duration of symptoms was 24 h. Four (30.7%) patients presented within 24 h onset of symptoms, whilst 9 (69.3%) patients presented after 24 h onset of symptoms. There were 5 (39.5%) patients, who presented with abdominal pain without peritoneal signs on physical examination and 8 (61.5%) patients, who had peritoneal signs. The mortality rate was 20% (1/5) in the first group who presented without peritoneal signs, whilst it was 62.5% (5/8) in the remaining.ConclusionEarly intervention in AMI is the key to better results. CTA combined with early laparoscopy and LTT may have beneficial effects at this setting.

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Acute mesenteric ischemia

Abstract: We showed how an "interventional cardiologist's" approach to acute mesenteric ischemia was effective in restoring superior mesenteric artery patency and in aborting a mesenteric infarction.

Cited by 20 publications

References 3 publications

Intestinal ischemia: current treatment concepts

Intestinal ischemia: current treatment concepts

Endovascular Treatment for Acute Thromboembolic Occlusion of the Superior Mesenteric Artery and the Outcome Comparison between Endovascular and Open Surgical Treatments: A Retrospective Study

Local thrombolytic therapy in acute mesenteric ischemia

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