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Title: Endovascular Management of Acute Embolic Occlusion of the Superior Mesenteric Artery: A 12-Year Single-Centre Experience

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 to 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 %.
Authors:
; ; ;  [1] ;  [2] ; ;  [1] ; ;  [3] ;  [1] ;  [4] ; ;  [1] ;  [5] ;  [6]
  1. Faculty of Medicine at Charles University and University Hospital, Department of Radiology (Czech Republic)
  2. Faculty of Medicine at Charles University (Czech Republic)
  3. Faculty of Medicine at Charles University and University Hospital, Department of Surgery (Czech Republic)
  4. Faculty of Medicine at Charles University and University Hospital, Department of Cardiac Surgery (Czech Republic)
  5. Faculty of Medicine at Charles University, Computer Technology Center (Czech Republic)
  6. Faculty of Medicine at Charles University and University Hospital, Department of Medicine (Czech Republic)
Publication Date:
OSTI Identifier:
22469611
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 39; Journal Issue: 2; Conference: BSIR 2015: Britisch Society of Interventional Radiology 2015 annual meeting, Glasgow, Scotland (United Kingdom), 4-6 Nov 2015; 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; ALGORITHMS; ARTERIES; HOSPITALS; ISCHEMIA; MANAGEMENT; MEN; MORTALITY; PATIENTS; SURGERY; THERAPY; WOMEN