Endovascular Therapy as a Primary Revascularization Modality in Acute Mesenteric Ischemia

Cardiovascular and Interventional Radiology
Jussi M KärkkäinenHannu Manninen

Abstract

To evaluate endovascular therapy (EVT) as the primary revascularization method for acute mesenteric ischemia (AMI). A retrospective review was performed on all consecutive patients treated for AMI during a 5-year period (January 2009 to December 2013). EVT was attempted in all patients referred for emergent revascularization. Surgical revascularization was performed selectively after failure of EVT. Patient characteristics, clinical presentation, and outcomes were studied. Failures and complications of EVT were recorded. Fifty patients, aged 79 ± 9 years (mean ± SD), out of 66 consecutive patients with AMI secondary to embolic or thrombotic obstruction of the superior mesenteric artery were referred for revascularization. The etiology of AMI was embolism in 18 (36 %) and thrombosis in 32 (64 %) patients. EVT was technically successful in 44 (88 %) patients. Mortality after successful or failed EVT was 32 %. The rates of emergency laparotomy, bowel resection, and EVT-related complication were 40, 34, and 10 %, respectively. Three out of six patients with failure of EVT were treated with surgical bypass. EVT failure did not significantly affect survival. EVT is feasible in most cases of AMI, with favorable patient outcome and acc...Continue Reading

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Citations

Sep 1, 2015·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·M Björck
Nov 11, 2015·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Jussi M KärkkäinenHannu Manninen
Apr 29, 2015·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Jussi M KärkkäinenHannu Paajanen
Jul 14, 2016·Expert Review of Gastroenterology & Hepatology·J M Kärkkäinen
Jan 26, 2017·Vascular and Endovascular Surgery·Yoichi MiuraHidenori Suzuki
May 27, 2017·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Theodosios BisdasGiovanni Torsello
May 15, 2018·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Shuzo KanasakiSyerikjan Tulyeubai
Sep 5, 2019·World Journal of Surgery·B MurphyD C Winter
Feb 19, 2016·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Stefano SartiniMarcello Pastorelli
Jul 29, 2017·Cardiovascular and Interventional Radiology·Giancarlo SalsanoFrancesco Santini
May 9, 2019·Current Gastroenterology Reports·Vivek S PrakashPeter L Faries
Apr 20, 2021·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·J M Kärkkäinen
Apr 19, 2019·International Journal of Surgery·Sualeh Muslim KhanMuhammad Akbar Agha
Jun 18, 2021·Texas Heart Institute Journal·Teodora DonisanSerban Mihai Balanescu

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