Preoperative Planning for Superior Mesenteric Artery Aneurysm

Dumitrescu, Cristiana Iulia; Ciobirca, Catalin; Popa, Radu; Dumitrescu, Daniela; Tambura, Cornel Gheorghe; Ciobîrcă, Diana Maria; Stavaru, Radu; Tiuca, Mihai Florin; Maces, Suzana; Bărbulescu, Lucian-Florentin; Popa, Liliana Didi; Cazacu, Sergiu Marian

doi:10.3390/app112110311

Cited by 4 publications

(3 citation statements)

References 18 publications

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“…Los AAMS no rotos, por lo general, se detectan incidentalmente en la tomografía computarizada (TC), y debido al mayor uso de esta tecnología en la atención médica su detección ha aumentado. Otras técnicas de imagen diagnóstica son la resonancia magnética (RM), la angiografía por tomografía computarizada (CTA) y la ecografía abdominal (5) .…”

Section: Discussionunclassified

“…La imagenología tiene un papel muy importante no solo en el diagnóstico sino también en la planificación del tratamiento. Es importante realizar imágenes abdominales axiales adicionales ya que en estas imágenes es posible determinar múltiples parámetros para la cirugía, como el tamaño del aneurisma, del cuello aneurismático, los vasos accesorios (5) , e incluso para detectar variaciones anatómicas que complicarían el tratamiento (7) .…”

Section: Discussionunclassified

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Aneurisma de arteria mesentérica superior: causa muy rara de epigastralgia

Salas-Cuadros,

Gamero-Oppe,

Villavicencio-Palomino

2023

An Fac med

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Se describe el primer caso de tratamiento quirúrgico exitoso de un aneurisma de arteria mesentérica superior en el Hospital Regional III Honorio Delgado de Arequipa. El paciente presentó dolor epigástrico de 18 meses de evolución que fue diagnosticado mediante tomografía y angiotomografía computarizada. Fue sometido a laparotomía para resección de aneurisma y se realizó un bypass de arteria mesentérica superior utilizando un injerto de politetrafluoroetileno. El paciente tuvo una recuperación rápida y sin complicaciones y ha evolucionado adecuadamente hasta la fecha. Este tipo de aneurisma es raro, no contamos con incidencias reportadas en Perú. El tratamiento quirúrgico requiere una planificación cuidadosa debido al alto riesgo de ruptura y mortalidad. El apoyo tecnológico es primordial en la aproximación quirúrgica de este tipo de pacientes, lo cual muchas veces es un reto en hospitales públicos no especializados.

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Section: Discussionunclassified

Aneurisma de arteria mesentérica superior: causa muy rara de epigastralgia

Salas-Cuadros,

Gamero-Oppe,

Villavicencio-Palomino

2023

An Fac med

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“…However, this procedure is technically challenging and requires expertise in ultrasound imaging, visceral arterial hemodynamics, and duplex scan interpretation. On the other hand, CTA with 2D and 3D imaging can provide excellent reconstructions of the visceral arteries and is recommended as the initial imaging study in many studies [4,[27][28][29][30][31][32][33][34][35][36][37]. Furthermore, centerline analysis may be helpful in increasing the accuracy of the measurement of the stenosis and is especially appropriate for preoperative planning of endovascular treatment.…”

Section: Discussionmentioning

confidence: 99%

Development of a Novel Scoring Model to Estimate the Severity Grade of Mesenteric Artery Stenosis

Omran

Konietschke

Mueller

et al. 2022

JCM

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Objective: This study aimed to derive a new scoring model from estimating the severity grade of mesenteric artery stenosis. We sought to analyze the relationship between the new scoring model and the development, treatment, and mortality of chronic mesenteric ischemia (CMI). Methods: This retrospective study included 242 patients (128 (53%) women and 114 (47%) men) with suspected CMI from January 2011 to December 2020. A weighted sum six-point score (CSI-score; the celiac artery is abbreviated by “C”, superior mesenteric artery by “S”, and inferior mesenteric artery by “I”) based on the number of affected vessels and the extent and grade of the stenosis or occlusion of the involved visceral arteries was derived by maximizing the area under the ROC curve. The calculated CSI-score ranged from 0 to 22. The patients were divided according to the best cut-off point into low-score (CSI-score < 8) and high-score (CSI-score ≥ 8) groups. Results: The area under the receiver operating characteristic curve (AUC) of the CSI-score was 0.86 (95% CI, 0.82–0.91). The best cut-off point of “8” represented the highest value of Youden’s index (0.58) with a sensitivity of 87% and specificity of 72%. The cohort was divided according to the cut-off point into a low-score group (n = 100 patients, 41%) and high-score group (n = 142 patients, 59%) and according to the clinical presentation into a CMI group (n = 109 patients, 45%) and non-CMI group (n = 133 patients, 55%). The median CSI-score for all patients was 10 (range: 0 -22). High-scoring patients showed statistically significant higher rates of coronary artery disease (54% vs. 36%, p = 0.007), chronic renal insufficiency (50% vs. 30%, p = 0.002), and peripheral arterial disease (57% vs. 16%, p < 0.001). A total of 109 (45%) patients underwent invasive treatment of the visceral arteries and were more often in the high-score group (69% vs. 11%, p < 0.001). Of those, 79 (72%) patients underwent primary endovascular treatment, and 44 (40%) patients underwent primary open surgery or open conversion after endovascular treatment. Sixteen (7%) patients died during the follow-up, with a statistically significant difference between high- and low-scoring patients (9% vs. 0%, p = 0.008). The score stratification showed that the percentage of patients treated with endovascular and open surgical methods, the recurrence of the stenosis or failure of the endovascular treatment, the need for a bypass procedure, and the mortality rates significantly increased in the subgroups. The CSI-score demonstrated an excellent ability to discriminate between patients who needed treatment and those who did not, with an AUC of 0.87 (95% CI, 0.82–0.91). Additionally, the CSI-score’s ability to predict the patients’ mortality was moderate, with an AUC of 0.73 (95% CI, 0.62–0.83). Conclusions: The new scoring model can estimate the severity grade of the stenosis of the mesenteric arteries. Our study showed a strong association of the score with the presence of chronic mesenteric ischemia, the need for treatment, the need for open surgery, and mortality.

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Segmentation of Different Human Organs on 3D Computer Tomography and Magnetic Resonance Imaging using an Open Source 3D U-Net Framework

Popa

Bărbulescu

et al. 2022

2022 23rd International Carpathian Control Conference (ICCC)

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Preoperative Planning for Superior Mesenteric Artery Aneurysm

Cited by 4 publications

References 18 publications

Aneurisma de arteria mesentérica superior: causa muy rara de epigastralgia

Aneurisma de arteria mesentérica superior: causa muy rara de epigastralgia

Development of a Novel Scoring Model to Estimate the Severity Grade of Mesenteric Artery Stenosis

Segmentation of Different Human Organs on 3D Computer Tomography and Magnetic Resonance Imaging using an Open Source 3D U-Net Framework

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