Endovaskuläre Möglichkeiten und Grenzen bei akuten und chronischen mesenterialen Verschlussprozessen

Luther, B; Meyer, Frank; Mamopoulos, Apostolos; Zapenko, Alexander; Doerbecker, R.; Wullstein, C.; Kroeger, Knut; Katoh, Marcus

doi:10.1055/s-0034-1383234

Cited by 3 publications

(1 citation statement)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In case of thrombotic occlusion with absence of gangrenous bowel, revascularization is attempted either with antegrade or retrograde aortomesenteric bypass or with transaortic endarterectomy. In case of spontaneous dissection of the SMA before the onset of intestinal infarction successful percutaneous stent placement has been reported [39,45,46] . Significant incidence of AMI has also been referred after aortic aneurysm repair.…”

Section: Diagnostic Modalitiesmentioning

confidence: 99%

Mesenteric ischemia: Pathogenesis and challenging diagnostic and therapeutic modalities

Mastoraki¹

2016

WJGP

View full text Add to dashboard Cite

Mesenteric ischemia (MI) is an uncommon medical condition with high mortality rates. ΜΙ includes inadequate blood supply, inflammatory injury and eventually necrosis of the bowel wall. The disease can be divided into acute and chronic MI (CMI), with the first being subdivided into four categories. Therefore, acute MI (AMI) can occur as a result of arterial embolism, arterial thrombosis, mesenteric venous thrombosis and nonocclusive causes. Bowel damage is in proportion to the mesenteric blood flow decrease and may vary from minimum lesions, due to reversible ischemia, to transmural injury, with subsequent necrosis and perforation. CMI is associated to diffuse atherosclerotic disease in more than 95% of cases, with all major mesenteric arteries presenting stenosis or occlusion. Because of a lack of specific signs or due to its sometime quiet presentation, this condition is frequently diagnosed only at an advanced stage. Computed tomography (CT) imaging and CT angiography contribute to differential diagnosis and management of AMI. Angiography is also the criterion standard for CMI, with mesenteric duplex ultrasonography and magnetic resonance angiography also being of great importance. Therapeutic approach of MI includes both medical and surgical treatment. Surgical procedures include restoration of the blood flow with arteriotomy, endarterectomy or anterograde bypass, while resection of necrotic bowel is always implemented. The aim of this review was to evaluate the results of surgical treatment for MI and to present the recent literature in order to provide an update on the current concepts of surgical management of the disease. Mesh words selected include MI, diagnostic approach and therapeutic management.

show abstract

Section: Diagnostic Modalitiesmentioning

confidence: 99%

Mesenteric ischemia: Pathogenesis and challenging diagnostic and therapeutic modalities

Mastoraki¹

2016

WJGP

View full text Add to dashboard Cite

show abstract

The Ongoing Challenge of Acute Mesenteric Ischemia

et al. 2018

View full text Add to dashboard Cite

Background: The lethality of acute mesenteric ischemia (AMI) remains quite high with 50-70%. The main reasons for that are the fact that AMI is rarely taken into consideration by the differential diagnosis of acute abdomen, the time-consuming diagnostic process, and the lack of a standardized therapeutic concept. The present interdisciplinary review aims to increase awareness among physicians and to help improve clinical outcomes. Methods: This clinical therapeutic review is based on author expertise as well as a selective literature survey in PubMed based on the term ‘mesenteric ischemia', combined with the terms ‘arterial', ‘clinical presentation', ‘diagnosis', ‘therapy', ‘surgery', and ‘interventional radiology'. Based on these search results as well as on the guidelines of the German Society of Vascular Surgery, the American College of Cardiology, and the American Heart Association, we present an interdisciplinary treatment concept. Results: AMI is a vascular emergency that can be successfully treated only within the first hours after the onset of symptoms. Computed tomography angiography is the diagnostic method of choice. Intensive care unit treatment can prevent the occurrence of multiple organ failure. Treatment primarily consists of the revascularization of the mesenteric arteries. Endovascular techniques should be given priority, whereas signs of peritonitis or a central arterial occlusion with high thrombus load primarily require a surgical approach in order to save time and increase patient safety. Additional bowel resections can play a significant role in the treatment of intestinal sepsis. Conclusion: Prompt and goal-oriented diagnosis and consistent treatment of AMI within 4-6 h from the onset of symptoms can be decisive for the reduction of AMI-associated lethality. In order for this to happen, a standardized concept of emergency treatment needs to be implemented.

show abstract

A Review on Aorta Mesenteric Bypass in Surgical Management of Mesenteric Ischemia: Indications, Techniques and Outcomes

Coco

Leanza²

2020

Maedica

View full text Add to dashboard Cite

Endovaskuläre Möglichkeiten und Grenzen bei akuten und chronischen mesenterialen Verschlussprozessen

Cited by 3 publications

References 20 publications

Mesenteric ischemia: Pathogenesis and challenging diagnostic and therapeutic modalities

Mesenteric ischemia: Pathogenesis and challenging diagnostic and therapeutic modalities

The Ongoing Challenge of Acute Mesenteric Ischemia

A Review on Aorta Mesenteric Bypass in Surgical Management of Mesenteric Ischemia: Indications, Techniques and Outcomes

Contact Info

Product

Resources

About