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Acute mesenteric ischemia (Part II) - Vascular and endovascular surgical approaches

Kärkkäinen, Jussi M. and Acosta, Stefan LU (2017) In Bailliere's Best Practice and Research in Clinical Gastroenterology 31(1). p.27-38
Abstract

The modern treatment of acute mesenteric ischemia (AMI) requires seamless collaboration of gastrointestinal surgeons, vascular surgeons, and interventional radiologists. The treatment strategy is straightforward aiming at rapid restoration of blood flow to the intestine. Bowel resection is performed on demand. The first thing to consider is the patient's clinical condition at presentation, whether there are signs of peritonitis or not, and whether the patient is hemodynamically stable or not. Second, there are four etiologies of AMI that need to be distinguished as they differ in treatment: superior mesenteric artery embolism, mesenteric arterial occlusive disease, mesenteric venous thrombosis, and non-occlusive mesenteric ischemia. In... (More)

The modern treatment of acute mesenteric ischemia (AMI) requires seamless collaboration of gastrointestinal surgeons, vascular surgeons, and interventional radiologists. The treatment strategy is straightforward aiming at rapid restoration of blood flow to the intestine. Bowel resection is performed on demand. The first thing to consider is the patient's clinical condition at presentation, whether there are signs of peritonitis or not, and whether the patient is hemodynamically stable or not. Second, there are four etiologies of AMI that need to be distinguished as they differ in treatment: superior mesenteric artery embolism, mesenteric arterial occlusive disease, mesenteric venous thrombosis, and non-occlusive mesenteric ischemia. In this review, we describe the basic vascular and endovascular treatment modalities accompanied by a simple algorithm for the various situations in AMI. Furthermore, the indications for damage control and primary definitive surgery are discussed.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Acute mesenteric ischemia, Acute on chronic mesenteric ischemia, Angioplasty, Embolectomy, Endovascular procedures, Endovascular therapy, Mechanical thrombolysis, Mesenteric venous thrombosis, Nonocclusive mesenteric ischemia, Surgical treatment
in
Bailliere's Best Practice and Research in Clinical Gastroenterology
volume
31
issue
1
pages
27 - 38
publisher
Baillière Tindall
external identifiers
  • scopus:85009476077
  • wos:000400719800004
ISSN
1521-6918
DOI
10.1016/j.bpg.2016.11.003
language
English
LU publication?
yes
id
a3c235b3-2cec-4090-9f3b-291f225685c2
date added to LUP
2017-02-10 13:30:59
date last changed
2018-01-07 11:49:13
@article{a3c235b3-2cec-4090-9f3b-291f225685c2,
  abstract     = {<p>The modern treatment of acute mesenteric ischemia (AMI) requires seamless collaboration of gastrointestinal surgeons, vascular surgeons, and interventional radiologists. The treatment strategy is straightforward aiming at rapid restoration of blood flow to the intestine. Bowel resection is performed on demand. The first thing to consider is the patient's clinical condition at presentation, whether there are signs of peritonitis or not, and whether the patient is hemodynamically stable or not. Second, there are four etiologies of AMI that need to be distinguished as they differ in treatment: superior mesenteric artery embolism, mesenteric arterial occlusive disease, mesenteric venous thrombosis, and non-occlusive mesenteric ischemia. In this review, we describe the basic vascular and endovascular treatment modalities accompanied by a simple algorithm for the various situations in AMI. Furthermore, the indications for damage control and primary definitive surgery are discussed.</p>},
  author       = {Kärkkäinen, Jussi M. and Acosta, Stefan},
  issn         = {1521-6918},
  keyword      = {Acute mesenteric ischemia,Acute on chronic mesenteric ischemia,Angioplasty,Embolectomy,Endovascular procedures,Endovascular therapy,Mechanical thrombolysis,Mesenteric venous thrombosis,Nonocclusive mesenteric ischemia,Surgical treatment},
  language     = {eng},
  number       = {1},
  pages        = {27--38},
  publisher    = {Baillière Tindall},
  series       = {Bailliere's Best Practice and Research in Clinical Gastroenterology},
  title        = {Acute mesenteric ischemia (Part II) - Vascular and endovascular surgical approaches},
  url          = {http://dx.doi.org/10.1016/j.bpg.2016.11.003},
  volume       = {31},
  year         = {2017},
}