Angioplasty and stenting of the superior mesenteric artery in acute mesenteric ischaemia

2004 ◽  
Vol 48 (3) ◽  
pp. 426-429 ◽  
Author(s):  
RP Lim ◽  
RJ Dowling ◽  
KR Thomson
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mesenteric Ischaemia ◽  
Acute Mesenteric Ischaemia ◽  
Angioplasty And Stenting

Occlusion of the celiac trunk, the inferior mesenteric artery and stenosis of the superior mesenteric artery in peripheral thrombangiitis obliterans

VASA ◽  
2009 ◽  
Vol 38 (4) ◽  
pp. 394-396 ◽  
Author(s):  
Çakmak ◽  
Gyedu ◽  
Akyol ◽  
İ. Kepenekçi ◽  
Köksoy
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Celiac Trunk ◽  
Occlusive Disease ◽  
Mesenteric Ischaemia ◽  
Buerger’S Disease ◽  
Buerger's Disease ◽  
Acute Mesenteric Ischaemia ◽  
Thrombangiitis Obliterans

Buerger‘s disease is an inflammatory occlusive disease which commonly involves medium-sized or smaller vessels of extremities. Mesenteric involvement in Buerger‘s disease is very rare. It can occur at any time during the course of the disease and presents with acute mesenteric ischaemia. In this study, a case of Buerger‘s disease with mesenteric involvement diagnosed before the onset of acute mesenteric ischaemia and managed endovascularly is reported.

Endovascular Treatment for Acute Mesenteric Ischaemia in a Young Woman with Polyarterial Disease

2017 ◽  
Vol 26 (1) ◽  
pp. 81-84
Author(s):  
Mihai C. Ober ◽  
Călin Homorodean ◽  
Dan A. Tătaru ◽  
Antonia E. Macarie ◽  
Camelia D. Ober ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Bowel Perforation ◽  
Computed Tomographic Angiography ◽  
Mesenteric Ischaemia ◽  
Acute Mesenteric Ischaemia ◽  
Computed Tomographic ◽  
Coeliac Trunk ◽  
Tomographic Angiography

Background: Acute mesenteric ischaemia is a condition with a grim prognosis on conservative treatment. Endovascular revascularisation is a promising approach for some of these patients.Case report: We present the case of a 44-year-old woman with a history of severe arterial hypertension, left leg claudication, and overlooked symptoms of chronic mesenteric ischaemia for one year, who was admitted for severe abdominal pain for one week. Computed tomographic angiography (CTA) showed acute mesenteric ischaemia by occlusion of the coeliac trunk and the superior mesenteric artery (SMA), without bowel perforation. In addition, CTA showed tight left renal stenosis and left external iliac stenosis. We performed angioplasty with a stent of the SMA, followed by revascularisation of the left renal artery. On control injection, the SMA appeared re-occluded, requiring a second stent implantation and a loading dose of dual antiplatelet therapy, with a good final result. Subsequently, the clinical course was uneventful, with no need of surgical exploration; a second procedure was planned, aiming at iliac revascularisation. At one month, the patient was asymptomatic, with normal Doppler flow in the SMA. Angiographic control during iliac revascularisation procedure showed a permeable SMA with a good filling of the coeliac trunk territory. Because of the suspicion of fibro-muscular dysplasia as aetiology, coronary angiography and cerebral CTA were performed, in order to exclude other potential lesions.Conclusions: Endovascular revascularisation in AMI is a promising alternative to the surgical approach in patients presenting without bowel perforation. Nevertheless, its safety and many tactical details remain to be clarified. Existing networks for revascularisation in acute myocardial infarction may be useful for the implementation of this approach.Abbreviations: AMI: Acute Mesenteric Ischaemia; CTA: Computed Tomographic Angiography; ICU: Intensive Care Unit; SMA: Superior Mesenteric Artery; STEMI: ST-segment Elevation Myocardial Infarction.

Acute mesenteric ischaemia, a highly lethal disease with a devastating outcome

VASA ◽  
2006 ◽  
Vol 35 (2) ◽  
pp. 106-111 ◽  
Author(s):  
Safioleas ◽  
Moulakakis ◽  
Papavassiliou ◽  
Kontzoglou ◽  
Kostakis
Keyword(s):  
Mortality Rate ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Bowel Resection ◽  
Morbidity Rate ◽  
Time Interval ◽  
Mesenteric Ischaemia ◽  
Acute Mesenteric Ischaemia ◽  
Artery Embolism ◽  
Significant Difference

Background: Acute mesenteric ischaemia remains a serious condition requiring emergency surgical management. The mortality rate still remains high, due to the unspecific and delayed diagnosis and ranges from 59% to 100%. Purpose of our study is to present our experience in the management of the disease. Patients and methods: This is a retrospective study of 61 patients treated surgically for acute mesenteric ischaemia, between 1988 and 2004. All patients underwent a laparotomy. 75% of the patients were operated within the first 24 hours and the rest within 48 hours. Results: Superior mesenteric artery embolism occurred in 36 (59%), thrombosis in 21 (34%) and superior mesenteric vein thrombosis in 4 (7%) cases. In 49 (80%) cases, embolectomy or thrombectomy of the superior mesenteric artery with resection of the necrotic segment of the bowel was performed. Twelve cases (20%) were considered inoperable because of massive bowel necrosis. According to our study mortality and morbidity rate amounts to 75% and 80% respectively. No significant difference in the mortality rate between patients with embolism (75%) and thrombosis (76%) was found. However a significant increase of mortality rate was observed when the surgical intervention became afterwards the first 24-hour period. (72% versus 87%). Patients who underwent embolectomy or thrombectomy with bowel resection presented an improved survival rate compared with patients that underwent only bowel resection. (p = 0.019) Conclusions: Acute mesenteric ischaemia has the characteristics of a highly lethal condition and only early recognition and appropriate treatment can reduce the potential for a devastating outcome. The reduction of time interval from the beginning of symptoms up to the treatment remains the main critical important factor.

scholarly journals Multidisciplinary diagnostic and therapeutic approach to acute mesenteric ischaemia: A case report with literature review

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110048
Author(s):  
Jurij Janež ◽  
Jasna Klen
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Anticoagulation Therapy ◽  
Atherosclerotic Plaques ◽  
Cardiac Diseases ◽  
Mesenteric Ischaemia ◽  
Acute Mesenteric Ischaemia ◽  
Artery Embolism ◽  
Arterial Aneurysms ◽  
Work Up

Superior mesenteric artery embolisation is the most common cause of acute mesenteric ischaemia. Superior mesenteric artery embolisation can be caused by various cardiac diseases (myocardial ischaemia or infarction, atrial tachyarrhythmias, endocarditis, cardiomyopathies, ventricular aneurysms and valvular disorders), arterial aneurysms, ulcerated atherosclerotic plaques of the major arteries and others. A case of 65-year-old, previously healthy man with superior mesenteric artery embolism, who was found to also have mural aortic thrombi, is presented. The patient underwent an emergency procedure; small intestine and cecum were resected and jejuno-ascendo anastomosis was performed. The patient was put on lifelong anticoagulation therapy. Neither cardiac diseases nor arterial aneurysms were detected. There were no signs of underlying atherosclerosis. Work-up for antiphospholipid antibodies and rheumatic diseases was negative. Tumour markers were within normal levels and blood cultures were negative. This case represents the challenges in recognising an underlying cause of acute mesenteric embolism and highlights the importance of multidisciplinary diagnostic and treatment approach.

scholarly journals TP5.2.11 Intervention for mesenteric arterial insufficiency in octogenarians

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Sachin Shenoy ◽  
Kevin Daly ◽  
Wesley Stuart ◽  
Alan Meldrum ◽  
Keith Hussey
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Artery Occlusion ◽  
Mesenteric Ischaemia ◽  
Older Patient ◽  
Common Procedure ◽  
Endovascular Approach ◽  
Arterial Insufficiency ◽  
Chronic Mesenteric Ischaemia

Abstract Introduction Mesenteric ischaemia is associated with significant morbidity and mortality. The poor prognosis associated with mesenteric ischaemia may prejudice decision-making, particularly for an older patient group. We have explored outcomes following intervention for mesenteric ischaemia in patients aged over 80-years old. Methods This was a retrospective analysis of a database of intervention for mesenteric ischaemia from 2010 to 2020 from a regional vascular unit covering two Health Boards in Scotland. Patients aged 80-years and over were identified and patterns of intervention and outcome described. Results There were 23 procedures performed – there were 17 patients aged 80-years or over. There were 8 patients with acute presentations, 6 had isolated superior mesenteric artery occlusion and thromboembolectomy was the most common procedure (n = 4). Laparotomy was performed in all cases and bowel resection required in 3. At 30-days 4 patients had died, but patients who survived the index admission were still alive at 1-year and symptom free. Elective was performed on 9 patients. An endovascular approach was favoured (n = 7) with the superior mesenteric artery the preferred target. At 30-days 2 had died, but at 1-year there had only been 1 further death. Three patients experienced recurrent symptoms. The remaining patients were symptom free. Conclusion It is appropriate to consider mesenteric intervention for older patients with both acute and chronic mesenteric ischaemia. Meaningful survival can be achieved with good relief of symptoms and return to meaningful quality of life.

Treatment of a Totally Occluded Superior Mesenteric Artery Facilitated by Retrograde Crossing via Collaterals from the Celiac Artery

2007 ◽  
Vol 14 (5) ◽  
pp. 745-747 ◽  
Author(s):  
Jon Robken ◽  
Nicolas W. Shammas
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Common Femoral Artery ◽  
Percutaneous Treatment ◽  
Celiac Artery ◽  
Chronic Mesenteric Ischemia ◽  
New Approach ◽  
Guide Catheter ◽  
Endovascular Approach ◽  
Angioplasty And Stenting

Purpose: To present a new approach route for recanalization of a chronically occluded superior mesenteric artery (SMA). Technique: Percutaneous treatment of an SMA occlusion can be accomplished in some cases via retrograde crossing through collaterals from the celiac artery. From a right common femoral artery (CFA) approach, an 8-F RDC guide catheter is advanced to the origin of the celiac artery via. Using a 5-F angled Glidecath, a long 0.035-inch stiff Glidewire, and a Choice PT wire, the glide catheter is advanced via the celiac artery into the superior pancreaticoduodenal artery. Using the angled Glidewire and the Choice PT wire, the occluded SMA is cannulated in a retrograde fashion. Through an 8-F sheath in the left CFA, an 8-F RDC guide catheter is advanced into the abdominal aorta. A goose neck snare is used to capture the Choice wire, which is withdrawn through the left catheter and sheath. The SMA occlusion is dilated, and the RDC guide is advanced into the SMA origin over the balloon. Another Choice PT wire and a 0.035-inch Wholey High Torque wire are placed in an antegrade fashion through the now open SMA. Angioplasty and stenting are then completed in the SMA over the Wholey wire. Conclusion: Retrograde recanalization of the SMA via celiac collaterals offers a new endovascular approach to treating patients with chronic mesenteric ischemia and a chronically occluded SMA.

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