Chronic mesenteric ischemia: current state of the problem

Долгушина, А. И.; Шапошник, И. И.; Селянина, А. А.; Кузнецова, А. С.; Генкель, В. В.

doi:10.31146/1682-8658-ecg-178-6-166-172

Cited by 3 publications

(2 citation statements)

References 36 publications

(26 reference statements)

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“…Как при первичной (лечение бессимптомных пациентов), так и при вторичной (лечение пациентов с симптомами заболевания) профилактике атеросклеротического сосудистого заболевания текущие рекомендации по медикаментозному лечению основаны на оценке риска смерти от сердечно-сосудистого заболевания в течение 5-10 лет Обзоры литературы [2,36]. В то же время стоит отметить, что текущие рекомендации по вторичной фармакологической профилактике атеросклеротического поражения артерий, в основном, основаны на данных пациентов с коронарным, брахио цефальным атеросклерозом и атеросклерозом нижних конечностей, и специфической медикаментозной терапии для ХМИ не существует [36][37][38][39].…”

Section: медикаментозное лечение хмиunclassified

Chronic mesenteric ischemia: causes, methods of diagnosis and treatment

Bugurov

Karpenko

Osipova

et al. 2022

Cardiovasc Ther Prev

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Chronic mesenteric ischemia (CMI) is an urgent public health problem. The long asymptomatic course of the disease, sudden onset and an unfavorable prognosis in the absence of treatment make it necessary to pay closer attention to this pathology. There are currently two competitive treatments for CMI: surgical and endovascular revascularization. Despite numerous studies comparing these methods, the question of which one is more effective and reliable remains open. The review includes current data from clinical trials and meta-analyses demonstrating the advantages and disadvantages of both methods.

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Section: медикаментозное лечение хмиunclassified

Chronic mesenteric ischemia: causes, methods of diagnosis and treatment

Bugurov

Karpenko

Osipova

et al. 2022

Cardiovasc Ther Prev

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“…Атеросклеротический процесс в пораженных сосудах приводит к уплотнению их стенок, стенозированию или окклюзированию просвета и, таким образом, к полному нарушению их проходимости [2][3][4][5]. Экстравазальные и интравазальные (атеросклеротической этиологии) стенозы непарных висцеральных артерий, как изолированные, так и сочетанные, а также неокклюзионные ишемические состояния -являются причиной возникновения ишемических синдромов органов пищеварения в 52,2-88,3% случаев [6][7][8][9].…”

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Atherosclerosis of unpaired visceral branches of the abdominal aorta (clinical and instrumental diagnostics)

Shuleshova,

Lisitsa,

Danilov

et al. 2024

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Aim. To establish the prevalence of atherosclerotic lesions in the unpaired visceral artery branches of the abdominal aorta. To explore the features of clinical presentation, the state of the mucosa of the upper GI tract. Materials and methods. A total of 118 patients with atherosclerosis of the unpaired visceral artery branches of the abdominal aorta aged 45 to 89 years were examined. The comparison group included 120 patients without atherosclerosis in the unpaired visceral artery branches of the abdominal aorta. Patients in both groups had coronary atherosclerosis. Ultrasound dopplerography (USDG) as a screening technique, CT angiography, and MSCT aortography were used to verify occlusion-stenotic lesions in the unpaired visceral artery branches of the abdominal aorta. The diagnosis of erosion changes in the gastric mucosa was confirmed by clinical symptoms and endoscopic examination findings. Results. In our study, hemodynamically relevant stenosis (>70%) was identified in 28.8% of patients. The clinical presentation of atherothrombosis in mesenteric vessels was shown to be nonspecific. Abdominal pain was the most common symptom in the examined patients with abdominal angina (76.3%). The upper GI endoscopy in patients with a verified diagnosis of chronic abdominal ishemia (CAI) showed gastric mucosa atrophy (focal or diffuse) in 100% of cases. Gastric erosions are identified in 55.1% of patients. Gastric ulcers are observed in 27.1% of patients. Erosive and ulcerative lesions of the gastric mucosa are combined with atrophic changes in the mucosa. Erosive esophagitis was detected in 28.8% of patients. The frequency of detected focal abnormalities in the esophageal mucosa accounts for 27.3%, and those in the gastric mucosa is 54.2%, mainly due to intestinal metaplasia. Conclusion. Due to the increasing prevalence of obliterative vascular diseases, early detection of changes in the upper gastrointestinal tract remains an urgent challenge. The comprehensive endoscopic examination using additional endoscopic NBI and ZOOM techniques allows to identify all changes in the mucosa, including small focal abnormalities. Timely detection of the disease makes it possible to choose the right treatment method.

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Vascular abnormalities visualized by multislice computed tomography of the abdomen: accidental findings or immediate causes of pain syndrome? (topic review)

Arutiunova

Araslanova

Riabchenko

et al. 2021

Med. vestn. Ûga Ross.

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Abnormalities of the abdominal aorta branches may cause chronic mesenteric ischemia, progressive pathological changes of the internal organs in this setting, and chronic pain syndrome. The causes of chronic mesenteric ischemia may be divided into atherosclerotic and non-atherosclerotic. Atherosclerosis of the unpaired branches of the abdominal aorta involves stenosis or occlusion. Other causes include fibromuscular dysplasia, vasculitis (Takayasu, segmental mediolytic arteriopathy), and median arcuate ligament syndrome. These syndromes, the pathogenesis of some of which remains controversial, lead to nonspecific complaints such as abdominal pain, weight loss, and others. Digital subtraction angiography or duplex ultrasound may provide hemodynamic information in cases of vascular disease in this area. However, multislice spiral computed tomography is in many cases the first choice because it allows for a comprehensive assessment of the state of blood vessels and associated morphological changes of internal organs. Structural changes accompanying these syndromes can also occur in patients who are undergoing a medical examination for other reasons. However, these syndromes should not be diagnosed solely on the basis of imaging; instead, the findings should be compared with the clinical presentation, which implies collaboration of radiologists and clinicians.

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Chronic mesenteric ischemia: current state of the problem

Cited by 3 publications

References 36 publications

Chronic mesenteric ischemia: causes, methods of diagnosis and treatment

Chronic mesenteric ischemia: causes, methods of diagnosis and treatment

Atherosclerosis of unpaired visceral branches of the abdominal aorta (clinical and instrumental diagnostics)

Vascular abnormalities visualized by multislice computed tomography of the abdomen: accidental findings or immediate causes of pain syndrome? (topic review)

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