Acute mesenteric ischemia: Utility of endovascular techniques

Anna Serracant Barrera, Alexis Luna Aufroy, José Manuel Hidalgo Rosas, Gabriel Cánovas Moreno, José Ramón Fortuño Andres, Joan Falcó Fages, Salvador Navarro Soto

Research output: Contribution to journalArticleResearchpeer-review

5 Citations (Scopus)

Abstract

© 2015 AEC. Introduction: Acute mesenteric ischemia (AMI) has a high mortality. Early diagnosis and treatment are very important. In our institution there is a therapeutic protocol that includes endovascular techniques (ET) in patients with AMI without peritoneal irritation at diagnosis. The aim of this study was to evaluate the use of ET in conjunction with conventional surgery in the management of potentially reversible IMA diagnosed by computed tomography (CT-angiography). Methods: Observational, descriptive and retrospective study that evaluated the use of ET in patients with AMI (arterial origin) in 2 periods (before and after the application of a protocol that includes ET), between 2009-2013. All patients were diagnosed by a CT-angiography, as the diagnostic technique of choice, because of the clinical and analytical suspicion. Results: Our series included 73 patients with IMA diagnosed by CT-angiography (45: 2009-2011; 28: 2012-2013). Leukocytosis was common (82%), high lactate levels are less frequent (47% vs. 53%). There were 49 patients with IMA without peritoneal irritation. In 51% bowel resection surgery was performed (44% survival); 18%: revascularization by ET (survival 67%); 31%: palliative treatment (0% survival). 33% of patients undergoing first-line RVI needed a surgical rescue (bowel resection). The overall mortality was 67% (2009-2011) vs. 62% (2012-2013). Conclusions: Since the protocol application, there is a higher indication of ET in patients with AMI without peritoneal irritation, showing a decreased mortality. With ET application, there is a higher survival in these patients. In our experience, the use of ET in cases of AMI without peritoneal irritation at diagnosis, may increase survival.
Original languageEnglish
Pages (from-to)567-572
JournalCirugia Espanola
Volume93
Issue number9
DOIs
Publication statusPublished - 1 Jan 2015

Keywords

  • Acute mesenteric ischemia
  • Endovascular revascularization
  • Endovascular techniques

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