The value of combined elevation of D-dimer and neopterin as a predictive parameter for early stage acute mesenteric ischemia: An experimental study

Vascular ◽  
2016 ◽  
Vol 25 (2) ◽  
pp. 163-169 ◽  
Author(s):  
Ali Kagan Coskun ◽  
Zekai Halici ◽  
Akgun Oral ◽  
Yasin Bayir ◽  
Ferhat Deniz ◽  
...  
Keyword(s):  
Experimental Study ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Early Stage ◽  
Acute Mesenteric Ischemia ◽  
Artery Occlusion ◽  
Control Group ◽  
Blood Samples ◽  
D Dimer

Background The diagnosis of acute mesenteric ischemia is variable. Early diagnosis is important for reducing the mortality and morbidity rates. Aim This experimental study aims to investigate the diagnostic utility of D-dimer and neopterin as a marker for the early stage of acute mesenteric ischemia caused by occlusion of superior mesenteric artery. Methods The levels of D-dimer and neopterin were measured using an animal acute mesenteric ischemia model in 21 male rabbits. Superior mesenteric artery occlusion (Group 1, n = 14) and control (Group 2, n = 7) groups were identified. Blood samples at different times are collected from each rabbits. Blood samples from superior mesenteric artery occlusion group were taken 30 min after anesthesia but before laparotomy, 1, 2, and 3 h after superior mesenteric artery ligation. Blood samples from control group were taken 1 h before, 1 and 3 h after anesthesia and laparotomy. The D-dimer and neopterin levels of each blood sample were measured. Results The probability of acute mesenteric ischemia was found to be 36 times higher when the D-dimer level was over 0.125 ng/L, whereas the probability was 19.2 times higher when the neopterin level was over 1.25 nmol/L. Conclusions In this experimental study, the combined elevation of two significant markers, D-dimer and neopterin, may be helpful for the early diagnosis of acute mesenteric ischemia.

Hybrid Recanalization of Superior Mesenteric Artery Occlusion in Acute Mesenteric Ischemia

2008 ◽  
Vol 15 (1) ◽  
pp. 129-132 ◽  
Author(s):  
Björn Sonesson ◽  
Robert J. Hinchliffe ◽  
Nuno V. Dias ◽  
Timothy A. Resch ◽  
Martin Malina ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Acute Mesenteric Ischemia ◽  
Artery Occlusion ◽  
Superior Mesenteric Artery Occlusion ◽  
Mesenteric Artery Occlusion

Combined Endovascular and Surgical Retrograde Superior Mesenteric Artery Recanalization

2018 ◽  
Author(s):  
Syed M. Peeran
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Atherosclerotic Lesion ◽  
Acute Mesenteric Ischemia ◽  
Exploratory Laparotomy ◽  
Chronic Mesenteric Ischemia ◽  
Hybrid Technique ◽  
Current Standard ◽  
Stent Deployment

Acute mesenteric ischemia is a life-threatening vascular emergency associated with a very high mortality rate. In the setting of necrotic bowel, the current standard of care requires a laparotomy with bowel resection and surgical or endovascular revascularization of the superior mesenteric artery. Unfortunately, mesenteric bypass confers high perioperative mortality, in some reports up to 45%. A hybrid technique that employs an exploratory laparotomy, catheterization of the distal superior mesenteric artery, and stent deployment across the atherosclerotic lesion was first described in 2004 for the treatment of acute-on-chronic mesenteric ischemia. This chapter describes the appropriate clinical indications, the technical aspects of performing this hybrid procedure, as well as the challenges and common pitfalls encountered.

scholarly journals Necessity of revascularization for acute mesenteric ischemia in symptomatic patients with spontaneous isolated dissection of the superior mesenteric artery

Vascular ◽  
2019 ◽  
Vol 28 (1) ◽  
pp. 109-114
Author(s):  
Hiroyuki Otsuka ◽  
Atsushi Uehata ◽  
Keiji Sakurai ◽  
Toshiki Sato ◽  
Hiromichi Aoki ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Laboratory Data ◽  
Acute Mesenteric Ischemia ◽  
True Lumen ◽  
Bowel Necrosis ◽  
Abnormal Laboratory ◽  
Number Of Patients ◽  
Residual Ratio

Objectives We evaluated the necessity of revascularization for acute mesenteric ischemia in symptomatic patients with spontaneous isolated dissection of the superior mesenteric artery. Methods This retrospective study included 28 consecutive, symptomatic patients with spontaneous isolated dissection of the superior mesenteric artery treated at our hospital between December 2005 and December 2017. Patients with concomitant aortic dissection were excluded. We reviewed the patients’ clinical presentation; laboratory evaluations; computed tomography findings, including the true lumen residual ratio (i.e., the minimum true lumen size compared to the diameter of the transverse section of the dissected artery) at the time of admission; the number of patients who were suspected of having bowel ischemia; and the number of patients who required surgical or endovascular treatment and their outcomes. Additionally, to evaluate the true lumen residual ratio in symptomatic patients with bowel ischemia, the true lumen residual ratio in those with abnormal laboratory data were compared with that in those without abnormal laboratory data. Initial true lumen residual ratio values were also compared with final values. Furthermore, we assessed the clinical details of patients who had bowel necrosis. Categorical variables were compared using the χ2 test or Fisher’s exact test, and continuous values were presented as either the mean ± standard deviation or median (interquartile range 25–75%). Variables were analyzed using Student’s t-test or the Mann–Whitney U test. Results The patients’ age ranged between 41 and 85 years, and 25 were men. Although nine patients were suspected of having acute mesenteric ischemia, only one underwent bowel resection. None of the patients had an indication for revascularization. The true lumen residual ratio of the nine patients with abnormal laboratory data were significantly lower than those of the 19 without abnormal laboratory data (10 [0–25]% vs. 40 [20–50]%, p = 0.005). The patient who underwent bowel resection had a true lumen residual ratio of 10%; however, there was no obvious abnormal laboratory data suggestive of bowel necrosis. Dissections were managed conservatively in all patients. True lumen residual ratio increased from initial value of 30 (10–48)% to 98 (60-100)%at the final imaging study ( p < 0.0001). There were no adverse events related to the mesenteric circulation during the follow-up period of 2–11 years. Conclusions Reintervention is rarely required for spontaneous isolated dissection of the superior mesenteric artery, even in symptomatic patients, and spontaneous resolution of the luminal compromise is the rule.

scholarly journals Stent Placement for Acute Superior Mesenteric Artery Occlusion Associated with Type B Aortic Dissection

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Kazushi Suzuki ◽  
Masashi Shimohira ◽  
Takuya Hashizume ◽  
Yuta Shibamoto
Keyword(s):  
Aortic Dissection ◽  
Superior Mesenteric Artery ◽  
Stent Placement ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Artery Occlusion ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Superior Mesenteric Artery Occlusion ◽  
Mesenteric Artery Occlusion

A 50-year-old man had a mesenteric ischemia related to superior mesenteric artery (SMA) occlusion associated with a type B aortic dissection. We decided to perform stent placement for the SMA and could avoid mesenteric ischemia. We think the stent placement in the SMA might be an option for the treatment of mesenteric ischemia caused by aortic dissection.

Results of retrograde revascularizations of the superior mesenteric artery for acute mesenteric ischemia

2017 ◽  
Vol 44 ◽  
pp. 27-28
Author(s):  
Arnaud Roussel ◽  
Nellie Della Schiava ◽  
Raphael Coscas ◽  
Quentin Pellenc ◽  
Tarek Boudjelit ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Acute Mesenteric Ischemia

scholarly journals The value of potassium, pH and D-dimer levels in early diagnosis of acute mesenteric ischemia: an experimental study on rats

2021 ◽  
Vol 17 (1) ◽  
pp. 236-240
Author(s):  
Semih Hot ◽  
Seracettin Egin ◽  
Mehmet Ilhan ◽  
Suleyman Bademler ◽  
Okan Dikker ◽  
...  
Keyword(s):  
Experimental Study ◽  
Early Diagnosis ◽  
Mesenteric Ischemia ◽  
Peritoneal Lavage ◽  
Acute Mesenteric Ischemia ◽  
Lavage Fluid ◽  
Experimental Medicine ◽  
Peritoneal Lavage Fluid ◽  
Significant Difference ◽  
D Dimer

IntroductionThe aim of this randomized controlled experimental study was to evaluate the efficacy of potassium, pH and D-dimer levels in blood, as well as potassium and pH levels in peritoneal lavage fluid, in the early diagnosis of acute mesenteric ischemia.Material and methodsThis study was conducted at the Istanbul University Center of Experimental Medicine after having received approval from the Istanbul University animal testing ethics committee. Male albino Wistar rats (n = 24; 250 to 350 g) were divided into two control groups and two ischemic groups. Levels of potassium, pH, and D-dimer in blood and levels of potassium and pH in peritoneal lavage fluid were analyzed for 1 h and 2 h after the induced acute mesenteric ischemia procedure. The degree of ischemic injury was determined using the histopathological damage score in tissue samples taken from the terminal ileum.ResultsIschemic groups had statistically significant differences in potassium and pH in blood and peritoneal lavage fluid compared to non-ischemic groups (p < 0.05). There was no significant difference between control and ischemic groups in terms of D-dimer and histologic grading results after 1 h (p = 0.132, p = 0.475 respectively), while there was a significant difference between control and ischemic groups after 2 h (p < 0.05).ConclusionsThe levels of potassium, pH, and D-dimer could be useful in daily practice for the early diagnosis of acute mesenteric ischemia.

AN EMERGENT MANAGEMENT OF ACUTE SUPERIOR MESENTERIC ARTERY EMBOLISM WITH ILEAL GANGRENE

2021 ◽  
pp. 3-4
Author(s):  
Nishant Agarwal ◽  
Abhishek Kaushal ◽  
Shrey Aren ◽  
Srikanth Muraleedhar ◽  
Sudhir Kumar Panigrahi
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Intestinal Ischemia ◽  
Hospital Admissions ◽  
Bowel Resection ◽  
Acute Mesenteric Ischemia ◽  
Artery Embolism ◽  
Visceral Arteries ◽  
Bowel Gangrene

Acute mesenteric ischemia (AMI) occuring due to sudden, partial or complete interruption of blood ow in main visceral arteries of the abdomen eventually resulting in intestinal ischemia and/or bowel gangrene is a surgical emergency. It represents 0.1% of hospital admissions and 2% of the revascularization operations for atheromatous lesions. 50% of AMI is caused by embolic phenomenon, 25% by thrombotic episode and rest 25% by both. The most common vessel involved in AMI is superior mesenteric artery. Acute mesenteric embolic ischemia (AMEI) arises typically from a cardiac emboli in patients with atrial brillation or following MI. Patients usually presents with central abdominal pain, out of proportion to the physical ndings initially, later becoming diffuse associated with bloody diarrhoea during the episode. An early diagnosis, an aggressive resuscitation, intravascular or surgical restoration of blood ow and subsequent bowel resection based on bowel viability helps reduce morbidity and mortality.

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