Endovascular treatment of celiac and mesenteric arteries stenoses: Applications and results

Sharafuddin, Melhem J.; Olson, Craig; Sun, Shiliang; Kresowik, Timothy F.; Corson, John D.

doi:10.1016/s0741-5214(03)01030-9

Cited by 171 publications

(136 citation statements)

References 22 publications

(36 reference statements)

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“…[2][3][4] Balloon angioplasty for CMI has been reported occasionally after it was first used in 1980, 5 but patency in the chronic phase (6-24 months) is generally insufficient (about 50-80%). [6][7][8][9] The outcome of this procedure has been improved by the development of stents, and a review of recent reports [10][11][12][13][14][15] indicates a procedural success rate of 88-100% and a clinical success rate of 82-100%, with a complication rate of 3-16%. Twelve patients experienced complications in these reports: in 8 (67%) the complication occurred at a vascular access site (false aneurysm and hematoma in 4 and 4 patients, respectively), and arterial dissection, multiorgan failure, contrast medium-associated renal disorder, and arterial occlusion each occurred in 1 case.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Treatment of Chronic Mesenteric Ischemia

Soga

Yokoi

Iwabuchi

et al. 2008

Circ J

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Section: Discussionmentioning

confidence: 99%

Endovascular Treatment of Chronic Mesenteric Ischemia

Soga

Yokoi

Iwabuchi

et al. 2008

Circ J

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“…Finally, angiography may be the best diagnostic modality to confirm the diagnosis of median arcuate ligament syndrome, in which dynamic compression of the CA is demonstrated with a combination of inspiratory and expiratory images ( Fig. 1) [27].…”

Section: Angiographymentioning

confidence: 99%

“…Although one study documenting outcome following percutaneous transluminal angioplasty (PTA) of mesenteric vessels versus PTA with stenting found no difference in outcome [58], the overall trend has been toward increased use of PTA with stenting in endovascular therapy for CMI. Some investigators suggest this tendency results from extrapolation of data regarding endovascular treatment of renal artery stenosis, in which PTA and stenting remain more durable than PTA alone [27,59].…”

Section: Endovascular Therapymentioning

confidence: 99%

Acute and Chronic Mesenteric Ischemia

Herbert¹,

Steele²

2007

Surgical Clinics of North America

127

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“…5 Although prosthetic grafts in an antegrade or retrograde fashion provide the most durable means of repair, endovascular stenting and angioplasty have high early success rates and may be preferable for patients who have prohibitive risk factors for open surgery and who do not have evidence of infarcted bowel. 6 In cases in which bowel viability is questionable, multiple options including second-look operations are available and should be used, despite the relative lack of data showing improved outcomes. 7,8 Emerging diagnostic technologies may permit earlier diagnosis, allowing urgent treatment for mesenteric ischemia and potentially reducing the high mortality rates currently seen with this condition.…”

Section: Introductionmentioning

confidence: 99%

Analysis of incidence and the value of SOFA and MOD scoring in predicting the outcome in acute mesenteric ischemia

2015

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Background: Acute mesenteric ischemia (AMI) is defined as a sudden loss of blood supply to visceral tissue, and it potentially results in intestinal infarction. AMI is an uncommon (1-2 per 1000 hospital admissions) but highly complex clinical problem. Mortality from AMI remains high despite an aggressive approach consisting of early diagnosis, restoration of arterial perfusion, resection of nonviable intestine, second-look laparotomy, and supportive intensive care with an average from published reports ranging from 30% to 65%. Moreover, most series have not shown any improvement in mortality over the last 2 decades, regardless of the therapeutic approach applied. While major advances in the technology and availability of imaging modalities have made earlier diagnosis and treatment more feasible, this has been counterbalanced by the contemporary AMI patient presenting at an advanced age and with more severe underlying comorbidities. Likewise, mesenteric ischemia remains a highly morbid condition. According to the literatures, early diagnosis, resection of the unviable bowel, recovery of adequate blood flow, second-look laparotomy, and supportive intensive management are the basis of appropriate management. Methods: The aim of the study was to analyse the incidence of AMI in our institution during April 2011-September 2013 and to study the demographics of that population and to compare the efficacy of SOFA vs MOD scoring in predicting the outcome of the patient with AMI. Treatment, consisting of surgical embolectomy or bypass grafting, has also yielded only modest improvements; some have championed an endovascular-first treatment paradigm. Moreover, accurate perioperative assessment of the risk of in-hospital mortality in patients with AMI is poorly defined. Results: In our study 60.7% of the patients presented to the casualty within 24hrs of symptoms. Patients who presented later than 24hrs (39.3%) had a higher mortality rate of 60.7%.When SOFA score increased to greater than 13 all patients succumbed to the disease with a mortality of 100% in the groups with SOFA score 13-16 and 17-20. When MOD score increased to greater than 12 all patients succumbed to the disease with a mortality of 100% in the groups with MOD score 13-16 and 17-20. On comparing the predictive outcome of SOFA vs MOD scoring system, both had similar results in predicting mortality (p value < 0.0001). Conclusions: To conclude, both SOFA and MOD scoring systems have similar values in predicting mortality for acute mesenteric ischemia. Other considerations such as age, comorbid illness DM /HTN/ /CAD /CVA do influence the outcome.

show abstract

Endovascular treatment of celiac and mesenteric arteries stenoses: Applications and results

Abstract: Our experience suggests a potential role for endovascular therapy of celiac and mesenteric arterial occlusive disease in a variety of clinical scenarios, with a low incidence of complications and a high technical success rate.

Cited by 171 publications

References 22 publications

Endovascular Treatment of Chronic Mesenteric Ischemia

Endovascular Treatment of Chronic Mesenteric Ischemia

Acute and Chronic Mesenteric Ischemia

Analysis of incidence and the value of SOFA and MOD scoring in predicting the outcome in acute mesenteric ischemia

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