A Scoring-System for Angiographic Findings in Nonocclusive Mesenteric Ischemia (NOMI): Correlation with Clinical Risk Factors and its Predictive Value

Minko, Peter; Stroeder, Jonas; Groesdonk, Heinrich V.; Graeber, Stefan; Klingele, Matthias; Buecker, Arno; Schäfers, Hans Joachim; Katoh, Marcus

doi:10.1007/s00270-014-0844-y

Cited by 22 publications

(27 citation statements)

References 12 publications

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“…To objectively assess the angiographic findings and correlate them with the presence of NOMI, one study analysed images from 63 consecutive patients who underwent DSA for suspected NOMI after previous cardiac or major thoracic vessel surgery. 214 Vessel morphology and reflux of contrast into the aorta correlated with death, and reflux of contrast also correlated with lactate levels, suggesting that extensive bowel gangrene had already developed in these cases. Delayed PV filling did not correlate with death.…”

Section: The Role Of Imagingmentioning

confidence: 91%

Editor's Choice – Management of the Diseases of Mesenteric Arteries and Veins

Björck¹,

Koelemay²,

Acosta³

et al. 2017

European Journal of Vascular and Endovascular Surgery

498

226

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She participated very actively in the process of developing these guidelines, in particular the important chapters on chronic arterial and venous mesenteric ischaemia. Six days after the second meeting of the task force she died unexpectedly, to our great despair and loss. We honour her dedication and scientific integrity by completing these guidelines. Among many other commitments she was a very productive reviewer and an associate editor of this journal. You can read more about Paola's important contributions to science and to the vascular community in the April 2016 issue of the European Journal of Vascular and Endovascular Surgery. 1

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Section: The Role Of Imagingmentioning

confidence: 91%

Editor's Choice – Management of the Diseases of Mesenteric Arteries and Veins

Björck¹,

Koelemay²,

Acosta³

et al. 2017

European Journal of Vascular and Endovascular Surgery

498

226

View full text Add to dashboard Cite

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“…Mit der DSA können Gefäßveränderungen der A. mesenterica superior auf dem Niveau von Gefäßarkaden und Segmentarterienästen aufgrund der höheren Auflösung deutlich besser beurteilt werden [7]. Die Kontrastmitteldynamik im Sinne eines erhöhten peripheren mesenterialen Widerstands und die verzögerte Kontrastierung der Pfortader als Zeichen eines verzögerten venösen Abstroms aufgrund von mikrovaskulären Veränderungen können nur mit der DSA beurteilt werden [2,4]. Ein weiterer Vorteil der DSA liegt in der Möglichkeit, unmittelbar nach der Diagnostik sofort und zügig gezielte Therapiemaßnahmen einzuleiten.…”

Section: Digitale Subtraktionsangiografieunclassified

“…Die Durchführung einer Angiografie bei Verdacht auf NOMI ist eine einfache und schnelle Prozedur und sollte somit an allen Zentren mit einer Angiografieeinheit möglich sein [4]. Heutzutage sind die Invasivität des Eingriffs und die damit assoziierten möglichen Komplikationen aufgrund der kleinen Katheter-und Schleusengrößen (3 -5 F) als gering zu betrachten.…”

Section: Durchführungunclassified

Nicht okklusive mesenteriale Ischämie: Diagnostik und Therapie

Minko¹,

Stroeder²

2020

Gefäßmedizin Scan - Zeitschrift für Angiologie, Gefäßchirurgie,

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“…Overall, NOMI accounts for 5-15% of acute mesenteric ischemia cases [2,3] and is associated with high mortality rates ranging between 50 and 93%, primarily due to its association with severe comorbidities [3,5,6]. Contrary to well-known symptoms of acute occlusive arterial mesenteric ischemia, clinical signs of NOMI are often unspecific [3,4,7]. Moreover, the symptoms may be masked due to intubation and sedation of the critically ill patients, potentially leading to a delayed diagnosis [3,4,[7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…Contrary to well-known symptoms of acute occlusive arterial mesenteric ischemia, clinical signs of NOMI are often unspecific [3,4,7]. Moreover, the symptoms may be masked due to intubation and sedation of the critically ill patients, potentially leading to a delayed diagnosis [3,4,[7][8][9][10][11]. Laboratory tests (e.g., elevated serum lactate) in combination with increasing need of vasoconstrictive medications strengthen the clinical suspicion of non-occlusive mesenteric ischemia [3,4].…”

Section: Introductionmentioning

confidence: 99%

Non-occlusive mesenteric ischemia (NOMI): evaluation of 2D-perfusion angiography (2D-PA) for early treatment response assessment

et al. 2020

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Purpose To evaluate the feasibility of 2D-perfusion angiography (2D-PA) for the analysis of intra-procedural treatment response after intra-arterial prostaglandin E1 therapy in patients with non-occlusive mesenteric ischemia (NOMI). Methods Overall, 20 procedures in 18 NOMI patients were included in this retrospective case-control study. To evaluate intra-procedural splanchnic circulation changes, post-processing of digital subtraction angiography (DSA) series was performed. Regions of interest (ROIs) were placed in the superior mesenteric artery (SMA; reference), the portal vein (PV; ROI PV), as well as the aorta next to the origin of the SMA (ROI Aorta). Peak density (PD), time to peak (TTP), and area under the curve (AUC) were assessed, and parametric ratios 'target ROI PD, TTP, AUC /reference ROI' were computed and compared within treatment and control group. Additionally, a NOMI score was assessed pre-and post-treatment compared to 2D-PA. Results Vasodilator therapy leads to a significant decrease of the 2D-PA-derived values PD Aorta (p = 0.04) and AUC Aorta (p = 0.03). These findings correlated with changes of the simplified NOMI score, both for overall (4 to 1, p < 0.0001) and for each category. Prostaglandin application caused a significant increase of the AUC PV (p = 0.04) and TTP PV was accelerated without reaching statistical significance (p = 0.13). When compared to a control group, all 2D-PA values in the NOMI group (pre-and post-intervention) differed significantly (p < 0.05) with longer TTP Aorta/PV and lower AUC Aorta/PV and PD Aorta/PV. Conclusion 2D-PA offers an objective approach to analyze immediate flow and perfusion changes following vasodilatory therapies of NOMI patients and may be a valuable tool for assessing treatment response.

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A Scoring-System for Angiographic Findings in Nonocclusive Mesenteric Ischemia (NOMI): Correlation with Clinical Risk Factors and its Predictive Value

Abstract: The applied scoring system allows standardized interpretation of angiographic findings in NOMI patients. Beyond that the score seems to correlate well with risk factors of NOMI and outcome.

Cited by 22 publications

References 12 publications

Editor's Choice – Management of the Diseases of Mesenteric Arteries and Veins

Editor's Choice – Management of the Diseases of Mesenteric Arteries and Veins

Nicht okklusive mesenteriale Ischämie: Diagnostik und Therapie

Non-occlusive mesenteric ischemia (NOMI): evaluation of 2D-perfusion angiography (2D-PA) for early treatment response assessment

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