Endovascular Treatment of Chronic and Acute on Chronic Mesenteric Ischaemia: Results From a National Cohort of 245 Cases

Altintas, Ümit; Lawaetz, Martin; Motte, Louise de la; Riazi, Hadi; Lönn, Lars; Lindh, Mats; Sillesen, Henrik; Eiberg, Jonas

doi:10.1016/j.ejvs.2021.01.003

Cited by 18 publications

(27 citation statements)

References 29 publications

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“…However, recent national data from the only centre performing revascularization in Denmark, where all patients in this study with suspected CMI were referred to, are available. These data show symptom relief in 71% of the patients following endovascular treatment (Altintas, et al, 2021).…”

Section: Discussionmentioning

confidence: 93%

Chronic mesenteric ischaemia: the importance of the individual mesenteric artery

Høyer

Christensen

Sandermann

et al. 2021

Clin Physio Funct Imaging

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Atherosclerotic, constrictive or microvascular vessel disease can lead to chronic mesenteric ischaemia (CMI) with a nonspecific clinical presentation typically involving postprandial abdominal pain, weight loss, and bowel dysfunction (Kolkman and Geelkerken, 2017). CMI remains a rarely diagnosed condition; nonetheless, asymptomatic mesenteric artery stenosis is very common (Thomas, et al., 1998). Studies have shown that asymptomatic mesenteric artery stenosis is found in up to 18% of the general population (Bjorck, et al., 2017).

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Section: Discussionmentioning

confidence: 93%

Chronic mesenteric ischaemia: the importance of the individual mesenteric artery

Høyer

Christensen

Sandermann

et al. 2021

Clin Physio Funct Imaging

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“…In patients with early acute arterial embolism or thrombosis, the onset of intestinal ischemia is < 12 h, intestinal injury is usually in the reversible stage without obvious peritoneal irritation, and the lesions are located in the main trunk or branches. Endovascular catheter therapy combined with systemic anticoagulation can be the first choice for treatment[ 17 , 23 ]. In this case, the patient had acute abdominal pain, high blood pressure, and high-risk factors for dehydration, and the plasma D-dimer levels increased sharply.…”

Section: Discussionmentioning

confidence: 99%

Severe Klebsiella pneumoniae pneumonia complicated by acute intra-abdominal multiple arterial thrombosis and bacterial embolism: A case report

Bao¹,

Tang²,

Wang³

2022

World J Clin Cases

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BACKGROUND Klebsiella pneumoniae ( K. pneumoniae ) is a clinically common Gram-negative bacillus that can cause community- and hospital-acquired infections and lead to pneumonia, liver abscesses, bloodstream infections, and other infectious diseases; however, severe pneumonia caused by hypervirulent K. pneumoniae (hv Kp ) complicated by acute intra-abdominal multiple arterial thrombosis and bacterial embolism is rarely seen in the clinical setting and has not been reported in the literature. CASE SUMMARY A 51-year-old man was hospitalized with fever and dyspnea. Persistent mild pain in the middle and upper abdomen began at dawn on the 3 rd day following admission and developed into persistent severe pain in the left upper abdomen 8 h later. Based on chest computed tomography (CT), bronchoscopy, bronchoalveolar lavage fluid metagenomic next-generation sequencing, abdominal aortic CT angiography (CTA), and culture of the superior mesenteric artery embolus, adult community-acquired severe hv Kp pneumonia complicated by acute intra-abdominal multiple arterial thrombosis and bacterial embolism was diagnosed. Notably, he recovered and was discharged from the hospital after receiving effective meropenem anti-infection, endovascular contact thrombolytic, and systemic anticoagulant therapies and undergoing percutaneous thrombus aspiration. Ten days later, the patient returned to the hospital for abdominal CTA examination, which indicated blocked initial common pathway of the celiac trunk and superior mesenteric artery, and local stenosis. Therefore, celiac trunk artery stenting was performed in Chongqing Hospital, and postoperative recovery was good. CONCLUSION We report a case of hv Kp severe pneumonia complicated by acute intra-abdominal multiple arterial thrombosis and bacterial embolism and suggest that clinicians should consider the possibility of a Gram-negative bacillus infection and conduct effective pathogen detection in a timely fashion when managing patients with severe community-acquired pneumonia before obtaining bacteriologic and drug sensitivity results. At the same time, when patients have severe pulmonary infection complicated by severe abdominal pain, an acute mesenteric artery embolism should be considered to avoid delays in treatment.

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“…Endovascular revascularization as the sole intervention is sufficient in the early stage of AMI, whereas if surgery is required to explore the need for intestinal resection, surgical revascularization may be preferred. In modern hospitals with a hybrid operating theatre available, patients with AMI can profit from the combination of endovascular and open techniques [38]. The management of AMI is broadly summarized in Fig.…”

Section: Management and Outcomementioning

confidence: 99%

“…It is important to be aware of that patients with AMI who have a history of abdominal angina (abdominal pain after eating), and weight loss, sometimes combined with diarrhoea, most likely have suffered a thrombosis of a previous stenosis, or a further thrombosis due to slow blood flow distal of an occlusion. Such patients may be better candidates for endovascular revascularization than open surgery [38]. In patients with advanced chronic mesenteric ischemia with persisting symptoms, revascularization should not be postponed with a rationale to improve nutrition status preoperatively by administering PN [7].…”

Section: Specific Conditionsmentioning

confidence: 99%

Acute mesenteric ischaemia

Blaser

Forbes

Björck

2022

Current Opinion in Critical Care

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Purpose of reviewTo summarize the recent evidence on acute mesenteric ischaemia (AMI).Recent findingsThe overall incidence of AMI is below 10/100 000 person years but increases exponentially with age. The overall mortality of AMI remains high, exceeding 50%, despite continuing progress and increasing availability of imaging and endovascular interventions. However, patients with (early) revascularization have significantly better outcomes. The majority of patients surviving the acute event are still alive at 1 year, but evidence on quality of life is scarce.Clinical suspicion of AMI is the key to timely diagnosis, with biphasic computed tomography-angiography the diagnostic method of choice. Currently, no biomarker has sufficient specificity to diagnose AMI.SummaryImproved awareness and knowledge of AMI are needed to raise the suspicion of AMI in relevant patients and thereby to achieve better outcomes.

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Endovascular Treatment of Chronic and Acute on Chronic Mesenteric Ischaemia: Results From a National Cohort of 245 Cases

Cited by 18 publications

References 29 publications

Chronic mesenteric ischaemia: the importance of the individual mesenteric artery

Chronic mesenteric ischaemia: the importance of the individual mesenteric artery

Severe Klebsiella pneumoniae pneumonia complicated by acute intra-abdominal multiple arterial thrombosis and bacterial embolism: A case report

Acute mesenteric ischaemia

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