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Title: Regarding “Endovascular Management of Acute Embolic Occlusion of the Superior Mesenteric Artery: A 12-year Single Centre Experience”

Abstract

No abstract prepared.

Authors:
 [1];  [2]
  1. Faculty of Medicine at Charles University and University Hospital, Department of Radiology (Czech Republic)
  2. Faculty of Medicine at Charles University and University Hospital, Department of Surgery (Czech Republic)
Publication Date:
OSTI Identifier:
22642477
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 39; Journal Issue: 7; Other Information: Copyright (c) 2016 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ARTERIES; BIOMEDICAL RADIOGRAPHY; MANAGEMENT; THERAPY; VASCULAR DISEASES

Citation Formats

Raupach, Jan, E-mail: janraupach@seznam.cz, and Guňka, Igor, E-mail: gunka@email.cz. Regarding “Endovascular Management of Acute Embolic Occlusion of the Superior Mesenteric Artery: A 12-year Single Centre Experience”. United States: N. p., 2016. Web. doi:10.1007/S00270-016-1342-1.
Raupach, Jan, E-mail: janraupach@seznam.cz, & Guňka, Igor, E-mail: gunka@email.cz. Regarding “Endovascular Management of Acute Embolic Occlusion of the Superior Mesenteric Artery: A 12-year Single Centre Experience”. United States. doi:10.1007/S00270-016-1342-1.
Raupach, Jan, E-mail: janraupach@seznam.cz, and Guňka, Igor, E-mail: gunka@email.cz. 2016. "Regarding “Endovascular Management of Acute Embolic Occlusion of the Superior Mesenteric Artery: A 12-year Single Centre Experience”". United States. doi:10.1007/S00270-016-1342-1.
@article{osti_22642477,
title = {Regarding “Endovascular Management of Acute Embolic Occlusion of the Superior Mesenteric Artery: A 12-year Single Centre Experience”},
author = {Raupach, Jan, E-mail: janraupach@seznam.cz and Guňka, Igor, E-mail: gunka@email.cz},
abstractNote = {No abstract prepared.},
doi = {10.1007/S00270-016-1342-1},
journal = {Cardiovascular and Interventional Radiology},
number = 7,
volume = 39,
place = {United States},
year = 2016,
month = 7
}
  • No abstract prepared.
  • PurposeRetrospective evaluation of 12-year experience with endovascular management of acute mesenteric ischemia (AMI) due to embolic occlusion of the superior mesenteric artery (SMA).Materials and methodsFrom 2003 to 2014, we analysed the in-hospital mortality of 37 patients with acute mesenteric embolism who underwent primary endovascular therapy with subsequent on-demand laparotomy. Transcatheter embolus aspiration was used in all 37 patients (19 women, 18 men, median age 76 years) with embolic occlusion of the SMA. Adjunctive local thrombolysis (n = 2) and stenting (n = 2) were also utilised.ResultsWe achieved complete recanalization of the SMA stem in 91.9 %. One patient was successfully treated by surgical embolectomy due tomore » a failed endovascular approach. Subsequent exploratory laparotomy was performed in 73.0 % (n = 27), and necrotic bowel resection in 40.5 %. The total in-hospital mortality was 27.0 %.ConclusionPrimary endovascular therapy for acute embolic SMA occlusion with on-demand laparotomy is a recommended algorithm used in our centre to treat SMA occlusion. This combined approach for the treatment of AMI is associated with in-hospital mortality rate of 27.0 %.« less
  • The purpose of this study was to characterize the outcome of attempted endovascular intervention in patients with acute embolic or thrombotic superior mesenteric artery (SMA) occlusion. The records of 21 patients during a 3-year period between 2005 and 2008 were retrieved from the in-hospital registry. The first group included 10 patients (6 women and 4 men; median age 78 years) with acute embolic occlusion of the SMA. The median duration of symptoms from symptom onset to angiography was 30 hours (range 6 to 120). Synchronous emboli (n = 12) occurred in 6 patients. Embolus aspiration was performed in 9 patients,more » and 7 of these had satisfactory results. Complementary local thrombolysis was successful in 2 of 3 patients. Residual emboli were present at completion angiography in all 7 patients who underwent successful aspiration embolectomy, and bowel resection was necessary in only 1 of these patients. One serious complication occurred because of a long SMA dissection. The in-hospital survival rate was 90% (9 of 10 patients). The second group included 11 patients (10 women and 1 man; median age 68 years) with atherosclerotic acute SMA occlusions. The median time of symptom duration before intervention was 97 hours (range 17 to 384). The brachial, femoral, and SMA routes were used in 6, 7, and 5 patients, respectively. SMA stenting was performed through an antegrade (n = 7) or retrograde (n = 3) approach. Bowel resection was necessary in 4 patients. No major complications occurred. The in-hospital survival rate was 82% (9 of 11 patients). Endovascular therapy of acute SMA occlusion provides a good alternative to open surgery.« less
  • Endovascular treatment of acute mesenteric ischemia is rarely reported. We report a patient with a 1-year history of chronic mesenteric ischemia who presented with acute worsening of his symptoms and peritoneal signs. Aortography depicted an occlusion of the superior mesenteric artery, which was successfully managed with immediate percutaneous angioplasty (PTA) and stent placement. The patient's clinical condition improved markedly and an exploratory laparotomy performed the following day confirmed the viability of the intestine. He remains symptom-free 12 months after the procedure, and color Doppler follow-up showed that the stent is patent.
  • The case of a 30-year-old woman with a post-traumatic pseudoaneurysm of the superior mesenteric artery and associated celiac axis occlusion is presented. The patient was successfully treated with celiac artery recanalization and placement of a covered stent within the superior mesenteric artery. Follow-up at 3, 6, and 12 months and 3 years demonstrated patency of the covered stent and continued exclusion of the aneurysm. Although the long-term success of this procedure is unknown this management option should be considered where facilities are available, to reduce the increased morbidity associated with open surgical procedure.