Endovascular Versus Surgical Revascularization for the Management of Chronic Mesenteric Ischemia

2015 ◽  
Vol 49 (1-2) ◽  
pp. 37-44 ◽  
Author(s):  
Mahmud Saedon ◽  
Athanasios Saratzis ◽  
Ahmed Karim ◽  
Steve Goodyear
2019 ◽  
Vol 24 (3) ◽  
pp. 216-223 ◽  
Author(s):  
Fabio V Lima ◽  
Dhaval Kolte ◽  
David W Louis ◽  
Kevin F Kennedy ◽  
J Dawn Abbott ◽  
...  

There are limited contemporary data on readmission after revascularization for chronic mesenteric ischemia (CMI). This study aimed to determine the rates, reasons, predictors, and costs of 30-day readmission after endovascular or surgical revascularization for CMI. Patients with CMI discharged after endovascular or surgical revascularization during 2013 to 2014 were identified from the Nationwide Readmissions Database. The rates, reasons, length of stay, and costs of 30-day all-cause, non-elective, readmission were determined using weighted national estimates. Independent predictors of 30-day readmission were determined using hierarchical logistic regression. Among 4671 patients with CMI who underwent mesenteric revascularization, 19.5% were readmitted within 30 days after discharge at a median time of 10 days. More than 25% of readmissions were for cardiovascular or cerebrovascular conditions, most of which were for peripheral or visceral atherosclerosis and congestive heart failure. Independent predictors of 30-day readmission included non-elective index admission, chronic kidney disease (CKD), and discharge to home healthcare or to a skilled nursing facility. Revascularization modality did not independently predict readmission. In a nationwide, retrospective analysis of patients with CMI undergoing revascularization, approximately one in five were readmitted within 30 days. Predictors were largely non-modifiable and included non-elective index admission, CKD, and discharge disposition.


2017 ◽  
Vol 10 (23) ◽  
pp. 2440-2447 ◽  
Author(s):  
Fabio V. Lima ◽  
Dhaval Kolte ◽  
Kevin F. Kennedy ◽  
David W. Louis ◽  
J. Dawn Abbott ◽  
...  

2018 ◽  
Vol 02 (03) ◽  
pp. 217-222
Author(s):  
Leonard Dalag ◽  
Jonathan Lorenz ◽  
Thomas Tullius

AbstractChronic mesenteric ischemia (CMI) is a complex disorder, which typically affects elderly patients who classically present with longstanding abdominal pain and nonspecific clinical symptoms, such as food aversion and weight loss. The disease progression is often gradual due to a rich collateral network, and symptoms are generally not clinically apparent until two or more primary visceral arteries are affected. Symptomatic stenosis or occlusion of the mesenteric arteries can be the result of multiple etiologies, although atherosclerosis is the most common. Given its low incidence, a high clinical suspicion is necessary for diagnosis and to prevent a delay in treatment. Multiple imaging modalities are utilized to confirm the presence of mesenteric vessel involvement and to guide treatment. While open surgical revascularization was once the definitive treatment, endovascular management has become the first-line treatment for atherosclerotic CMI. The endovascular approach with stent placement has shown excellent primary success and encouraging long-term outcomes with reduction in morbidity and mortality compared with open surgical revascularization. Although controversial, median arcuate ligament syndrome (MALS) is a less common cause of CMI, which can affect a more varied patient population. Clinical approach, imaging characteristics, and treatment for this syndrome will also be discussed.


1997 ◽  
Vol 4 (4) ◽  
pp. 380-384 ◽  
Author(s):  
Jacques Busquet

Purpose: Abdominal angina is an early clinical expression of occlusive mesenteric arterial insufficiency, a condition that requires aggressive treatment to prevent intestinal infarction. We report a case of chronic mesenteric ischemia in a young polyvascular man who had symptoms of abdominal angina. Methods and Results: An aortic angiogram revealed a significant ostial stenosis of the superior mesenteric artery (SMA) associated with an occlusion of the inferior mesenteric artery. After predilation of the ostial portion of the SMA, significant residual stenosis remained. A balloon-expandable Palmaz P154 stent was deployed, restoring adequate luminal dimensions and blood flow. The patient was discharged after 2 days and remains asymptomatic at 5 months. Conclusion: Intraluminal stenting for treatment of mesenteric ischemia represents a viable alternative to surgical revascularization in selected cases.


2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Saleh Daher ◽  
Ziv Lahav ◽  
Ayman Abu Rmeileh ◽  
Meir Mizrahi ◽  
Tawfik Khoury

Gastric ulcer due to mesenteric ischemia is a rare clinical finding. As a result, few reports of ischemic gastric ulcers have been reported in the literature. The diagnosis of ischemic gastropathy is seldom considered in patients presenting with abdominal pain and gastric ulcers. In this case report, we describe a patient with increasing abdominal pain, weight loss, and gastric ulcers, who underwent extensive medical evaluation and whose symptoms were resistant to medical interventions. Finally he was diagnosed with chronic mesenteric ischemia, and his clinical and endoscopic abnormalities resolved after surgical revascularization of both the superior mesenteric artery and the celiac trunk.


2015 ◽  
Vol 18 (5) ◽  
pp. 219
Author(s):  
Ali Ihsan Parlar ◽  
Seyhan Babaroglu ◽  
Muhammet Onur Hanedan ◽  
Mehmet Ali Yürük ◽  
Salih Fehmi Katircioglu

<strong>Background:</strong> Chronic mesenteric ischemia and carotid stenosis frequently have coexistent coronary artery disease. Myocardial ischemia is the most common cause of morbidity and mortality following revascularization of the peripheral arteries. The optimal treatment of concurrent mesenteric, carotid, and coronary disease is unknown. <br /><strong>Case Report:</strong> We report a case of a 75-year-old man who required revascularization of the left anterior descending coronary and superior mesenteric arteries and carotid endarterectomy. After concomitant surgical revascularization, the patient remained asymptomatic during the 3-year follow-up. <br /><strong>Conclusion:</strong> A good result in this case encourages us for one-stage combined surgical intervention in patients who require multisystem revascularization.


2017 ◽  
Vol 34 (4) ◽  
pp. 340-349 ◽  
Author(s):  
Markus U. Wagenhäuser ◽  
Yvonne K. Meyer-Janiszewski ◽  
Philip Dueppers ◽  
Joshua M. Spin ◽  
Nikolaos Floros ◽  
...  

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