Acute Occlusive Mesenteric Ischemia: Surgical Management and Outcomes

Edwards, Matthew S.; Cherr, Gregory S.; Craven, Timothy E.; Olsen, Amy W.; Plonk, George W.; Geary, Randolph L.; Ligush, John; Hansen, Kimberley J.

doi:10.1007/s10016-001-0329-8

Cited by 141 publications

(108 citation statements)

References 17 publications

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“…In these patients, although visceral patency after TEVAR is excellent (up to 97%), 30-day mortality remains high (ranging between 31% and 62%), as well as aortic related complications during follow-up. [113][114][115] Uncomplicated TBAD. Management of uncomplicated TBAD is usually OMT; however, there is on-going debate about the possible beneficial role of TEVAR for these patients.…”

Section: Chronic Treatmentmentioning

confidence: 99%

Update in the management of type B aortic dissection

et al. 2016

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Stanford type B aortic dissection (TBAD) is a life-threatening aortic disease. The initial management goal is to prevent aortic rupture, propagation of the dissection, and symptoms by reducing the heart rate and blood pressure. Uncomplicated TBAD patients require prompt medical management to prevent aortic dilatation or rupture during subsequent follow-up. Complicated TBAD patients require immediate invasive management to prevent death or injury caused by rupture or malperfusion. Recent developments in diagnosis and management have reduced mortality related to TBAD considerably. In particular, the introduction of thoracic stent-grafts has shifted the management from surgical to endovascular repair, contributing to a fourfold increase in early survival in complicated TBAD. Furthermore, endovascular repair is now considered in some uncomplicated TBAD patients in addition to optimal medical therapy. For more challenging aortic dissection patients with involvement of the aortic arch, hybrid approaches, combining open and endovascular repair, have had promising results. Regardless of the chosen management strategy, strict antihypertensive control should be administered to all TBAD patients in addition to close imaging surveillance. Future developments in stent-graft design, medical therapy, surgical and hybrid techniques, imaging, and genetic screening may improve the outcomes of TBAD patients even further. We present a comprehensive review of the recommended management strategy based on current evidence in the literature.

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Section: Chronic Treatmentmentioning

confidence: 99%

Update in the management of type B aortic dissection

et al. 2016

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“…Therefore, early restoration of intestinal continuity is desirable. 1 The Bishop-Koop procedure was first described in 1957. 3 It involves anastomosing the end of the proximal limb of bowel to the side of distal bowel segment with exteriorisation of the end of the distal segment as an endstoma.…”

Section: Discussionmentioning

confidence: 99%

“…The mortality of acute mesenteric ischaemia is 40-60% and nearly a third of survivors develop short bowel syndrome and require long-term parenteral nutrition. 1 A two stage restoration of intestinal continuity has been advocated by some authors for critically ill patients who are at increased risk of anastomosis leakage due to presence of splanchnic hypoperfusion, hypoxia and acidosis. 2 However, delay in primary anastomosis will leave many patients with high output stomas.…”

mentioning

confidence: 99%

Early restoration of intestinal continuity in acute mesenteric ischaemia using Bishop–Koop stoma

Arsalani‐Zadeh

Kallam

Khan

et al. 2010

annals

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“…Surgical exploration is the treatment of choice if there is any evidence of an infarcted bowel. 19,20 Recently, it has been proven that a well-timed combined use of PTA and stent placement is effective and safe even for AMI. 5,6 In our last 2 AMI cases, urokinase, thrombectomy, and stent placement were used successfully after diagnosis of SMA occlusion.…”

Section: Discussionmentioning

confidence: 99%

Clinical Effectiveness of Percutaneous Angioplasty for Acute and Chronic Mesenteric Ischemia: A Six Case Series

Jung

Ahn

et al. 2011

Korean J Gastroenterol

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Intestinal ischemia is divided into three categories, namely, acute mesenteric ischemia (AMI), chronic mesenteric ischemia (CMI), and colonic ischemia. AMI can result from arterial or venous thrombi, emboli, and vasoconstriction secondary to low-flow states. It is an urgent condition which can result in high mortality rate. The predominant causative factor of CMI is stenosis or occlusion of the mesenteric arterial circulation, and it is characterized by postprandial abdominal pain and weight loss. Surgery is the treatment of choice for intestinal ischemia. However, it has been recently reported that percutaneous transluminal angioplasty with stent placement and/or thrombolysis is an effective therapy in various types of mesenteric ischemia. We report six cases of mesenteric ischemia which were successfully treated by percutaneous angioplasty, and review the literature from South Korea. (Korean J Gastroenterol 2011;57:243-248)

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Acute Occlusive Mesenteric Ischemia: Surgical Management and Outcomes

Cited by 141 publications

References 17 publications

Update in the management of type B aortic dissection

Update in the management of type B aortic dissection

Early restoration of intestinal continuity in acute mesenteric ischaemia using Bishop–Koop stoma

Clinical Effectiveness of Percutaneous Angioplasty for Acute and Chronic Mesenteric Ischemia: A Six Case Series

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