Revascularisation of atherosclerotic mesenteric arteries: Experience in 90 consecutive patients

Christensen, M. G.; Lorentzen, Jørgen; Schroeder, Torben V.

doi:10.1016/s0950-821x(05)80145-8

Cited by 54 publications

(27 citation statements)

References 15 publications

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“…Mamode et al 19 reported that angiography can be applied to only 5.3% of AMI cases and according to Acosta-Merida et al, 24 it is 13.6%. Park et al 16 reported that early revascularization decreases mortality rates nearly by half, whereas Christensen et al 25 reported that mortality rates are high (44%-90%) even in revascularized cases. For mesenteric arterial embolism, laparotomy and embolectomy are still the best treatment options.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors Effecting Mortality in Acute Mesenteric Ischemia and Mortality Rates: A Single Center Experience

Aliosmanoglu

Gül

Kapan

et al. 2013

International Surgery

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The objective of this study is to discuss the effective factors on morbidity and mortality in patients who were operated on for acute mesenteric ischemia. Between 2006 and 2011, 95 patients, who underwent emergent surgery for acute mesenteric ischemia, were analyzed retrospectively. The study group consisted of 56 men (58.9%) and 39 women (41.1%), with an average age of 68.4 ± 14.4 years. Elapsed time between the onset of the symptoms and the surgical operation was less than 24 hours in 47 (49.5%) cases, and more than 24 hours in 48 cases (50.5%) (P , 0.001). Although all of the patients had intestinal necroses, colon involvement was seen in 38 patients, and mortality was higher in this group of patients (P , 0.001). Mortality rate was 42.1%. This was higher in older patients, those with increased leukocyte levels, increased elapsed time to laparotomy, and when the colon was involved.

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Section: Discussionmentioning

confidence: 99%

Risk Factors Effecting Mortality in Acute Mesenteric Ischemia and Mortality Rates: A Single Center Experience

Aliosmanoglu

Gül

Kapan

et al. 2013

International Surgery

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“…The diagnosis and treatment algorithm are shown in Figure 1. Sepsis and multiple organ dysfunction syndromes occur in many patients with AMI, and the perioperative risk for mortality for revascularization ranges between 44% to 90% 30, 31 .…”

Section: Discussionmentioning

confidence: 99%

The role of imaging studies in critically ill medical patients with mesenteric ischemia

2013

SWRCCC

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CaseA 75-year-old man with a history of dementia living in a nursing home presented with septic shock with no definite source of infection and acute respiratory failure. He was on a moderate dose of norepinephrine and ventilator support for three days without improvement. His physical examination revealed abdominal distention with decreased bowel sounds. Do we need an abdominal CT scan in this patient? DisCussionImaging studies in critically ill patients in intensive care units help guide treatment. The most widely used radiographic studies that are non-invasive and associated with small or no radiation exposure available at the bedside in the ICU include chest radiography, plain abdominal radiography, and ultrasonography. Plain abdominal films are usually the first imaging studies ordered, are universally available, and are inexpensive 1, 2 . However, plain abdominal imaging is rarely helpful in diagnosis and has a low sensitivity and specificity in patients with an acute abdomen 3, 4 . Moreover, information obtained by plain abdominal radiography and abdominal ultrasonography in the ICU may be limited by bowel gas, wounds, catheters, tissue defects, and edema 5 . Abdominal imaging with multidetector computed tomography (MDCT) has become the most accurate method to study the abdomen [6][7][8] . It can be done quickly, and some hospitals have portable CT scans in the ICU. However, the use of abdominal CTs might be limited by the risks associated with patient transfer to the CT scan suite, the high cost, limited availability, and the increased workload of hospital personnel. Moreover, two-thirds of the radiation received by patients who stay in trauma ICUs longer than 30 days is from CT scans, and radiocontrast may cause nephrotoxicity and/or severe allergic reactions 9 . Hence, physicians need to evaluate the risks and benefits before transferring a patient to a CT scan suite. This decision may be difficult in intubated patients and/or patients with polytrauma or hemodynamic compromise, especially in patients with subtle abdominal symptoms, minimal physical findings, or uncertain sites of infection.There are no randomized controlled trials to delineate how soon, how often, and how helpful CT scans of the abdomen are in clinical decision making in the ICU. Patients with intestinal ischemia can have various clinical presentations which make the diagnosis difficult. We have reviewed recent studies on the role of CT scans of the abdomen in critically ill medical patients with mesenteric ischemia to develop some suggestions for the use of these studies in the ICU.Acute mesenteric ischemia (AMI) is a life threatening abdominal emergency with mortality rates ranging from 60 to 80% [10][11][12] . Mesenteric ischemia is caused by decreased blood flow to the intestine that results in hypoxic injury and then reperfusion damage at the cellular level. These events produce mucosal injury, tissue necrosis, and metabolic acidosis; released toxic metabolites and bacterial translocation contribute to the systemic inflammatory res...

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“…The AGA Technical Review on Intestinal Ischaemia reported that surgical revascularisation in a series of 614 patients was associated with a perioperative mortality rate ranging from 0 to 16% with success rates between 59 and 100% and recurrence rates from 0 to 26.5%. Several longterm studies have also shown that patients who survive surgical revascularisation have cumulative 5-year survival rates of 81-86% and life table analysis survival rates of 70-71 ± 11-15% [4,12,13].…”

Section: Discussionmentioning

confidence: 99%

Triple-vessel mesenteric ischaemia presenting with gastric ulceration

et al. 2011

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Revascularisation of atherosclerotic mesenteric arteries: Experience in 90 consecutive patients

Cited by 54 publications

References 15 publications

Risk Factors Effecting Mortality in Acute Mesenteric Ischemia and Mortality Rates: A Single Center Experience

Risk Factors Effecting Mortality in Acute Mesenteric Ischemia and Mortality Rates: A Single Center Experience

The role of imaging studies in critically ill medical patients with mesenteric ischemia

Triple-vessel mesenteric ischaemia presenting with gastric ulceration

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