scholarly journals Surgical Management of Acute Mesenteric Ischemia; Review Article

2021 ◽  
pp. 321-327
Author(s):  
Hashem Bark Awadh Abood ◽  
Mohammed Abduljalil Al Abdulwahhab ◽  
Omar Essam Altayyar ◽  
Ahmad Sayyaf Alrakhimi ◽  
Sawsan Yaseen Abdulla Ali Isa ◽  
...  
Keyword(s):  
Surgical Management ◽  
Observational Studies ◽  
Mesenteric Ischemia ◽  
Acute Mesenteric Ischemia ◽  
Review Article ◽  
Minimally Invasive Therapy ◽  
Endovascular Stenting ◽  
Arterial Embolism ◽  
Local Thrombolysis ◽  
Essential Components

Mesenteric ischemia is a condition in which the amount of oxygen available is insufficient to meet the needs of the intestines. The small intestine, colon, or both can be affected by ischemia. The most common cause of occlusive ischemia is an abrupt obstruction of a major artery, which causes a considerable drop in intestinal blood flow. Early diagnosis is one of the most essential components in achieving a favorable outcome. The most prevalent treatment is surgical management. However, there are minimally invasive therapy alternatives that have been shown in observational studies. For arterial thrombosis, endovascular stenting is an option, and anticoagulation is an option for venous thrombosis. Endovascular aspiration, mechanical embolectomy, and local thrombolysis are all possibilities for patients with arterial embolism.

Endovascular Procedures for Mesenteric Ischemia

2017 ◽  
Author(s):  
Gregory L. Moneta ◽  
Enjae Jung ◽  
Cherrie Z Abraham
Keyword(s):  
Mesenteric Ischemia ◽  
Acute Mesenteric Ischemia ◽  
Chronic Mesenteric Ischemia ◽  
Success Rates ◽  
Arterial Embolism ◽  
Endovascular Interventions ◽  
Catheter Directed Thrombolysis ◽  
Endovascular Approach ◽  
Open Versus ◽  
Angioplasty And Stenting

Mesenteric ischemia is a condition caused by compromised blood flow to the small and large intestines. Patients can present with chronic mesenteric ischemia (CMI), most commonly due to atherosclerosis, or acute mesenteric ischemia (AMI), most commonly due to arterial thrombosis or arterial embolism. Endovascular options for CMI include angioplasty and stenting, whereas options for AMI include catheter-directed thrombolysis and suction embolectomy followed by angioplasty and stenting of the underlying lesion. For treatment of CMI, an endovascular approach is associated with lower morbidity and mortality with good immediate technical success rates but may be less durable than surgical intervention, with reported lower long-term patency and a higher recurrence rate. There are no randomized trials comparing open versus endovascular interventions for AMI. Even after successful endovascular treatment, there should be a low threshold for laparotomy to visually inspect the bowel. Postoperative imaging is important, and close follow-up is mandatory.  This review contains 8 figures, and 26 references. Key words: acute mesenteric ischemia, angioplasty, catheter-directed thrombolysis, chronic mesenteric ischemia, stenting (balloon versus self-expandable, covered versus bare metal), suction embolectomy

Acute mesenteric ischemia with necrosis of entire small intestine

2019 ◽  
Vol 98 (4) ◽  
pp. 174-177
Keyword(s):  
Small Intestine ◽  
Mesenteric Ischemia ◽  
Severe Disease ◽  
Acute Mesenteric Ischemia ◽  
Diagnostic Methods ◽  
Entire Small Intestine ◽  
Common Etiology

The case study describes a case of a patient with acute mesenteric ischemia with necrosis of entire small intestine. In following text there is an overview of the incidence of acute mesenteric ischemia, its most common etiology, diagnostic methods and treatment of this severe disease.

Use of indocianine green fluorescence in acute mesenteric ischemia

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Jaime Bonnín-Pascual
Keyword(s):  
Indocyanine Green ◽  
Terminal Ileum ◽  
Mesenteric Ischemia ◽  
Intestinal Anastomosis ◽  
Acute Mesenteric Ischemia ◽  
Left Colon ◽  
Infrared Light ◽  
High Morbidity ◽  
Green Fluorescence ◽  
Clinical Cases

Introduction: Acute mesenteric ischemia has a high morbidity and mortality and constitutes an intraoperative challenge in the management of ischemic areas. In this context, we analyze the use of indocyanine green fluorescence to assess intestinal vascularization through 3 clinical cases. Case presentation: we present 3 clinical cases operated for acute mesenteric ischemia. Evaluation of intestinal viability is performed under infrared light after intravenous infusion of 25 mg of indocyanine green. Case 1 is a 42-year-old male with multiple antecedents of severe vascular disease, presenting with a massive acute mesenteric ischemia involving multiple intestinal segments. Fluorescence allows two adjusted bowel resections with double intestinal anastomosis. Case 2 is a 74-year-old woman with a history of non-anticoagulated atrial fibrillation who is decided to perform an urgent surgery when an esophageal, gastric and portal system pneumatosis is observed, as indirect signs of ischemia, in urgent CT. During the surgical act there is an ischemia of the terminal ileum and right colon without clear signs of involvement at the esophageal-gastric level. The assessment after administration of ICG discriminates the clear ischemic involvement from terminal ileum to ascending colon and patched in the transverse and left colon, without esophageal or gastric involvement. Case 3 is a 49-year-old woman with aortoiliac and visceral Takayasu disease and revascularization surgery of the celiac trunk. Given the increase in abdominal pain, a new CT scan demonstrates colonic pneumatosis. Urgent laparotomy shows necrosis at the level of the left colon and hypoperfusion of the cecum. The administration of ICG finds a lack of uptake of the entire colon. A subtotal colectomy with ileostomy and mucous fistula is performed. Introduction: Acute mesenteric ischemia has a high morbidity and mortality and constitutes an intraoperative challenge in the management of ischemic areas. In this context, we analyze the use of indocyanine green fluorescence to assess intestinal vascularization through 3 clinical cases. Case presentation: we present 3 clinical cases operated for acute mesenteric ischemia. Evaluation of intestinal viability is performed under infrared light after intravenous infusion of 25 mg of indocyanine green. Case 1 is a 42-year-old male with multiple antecedents of severe vascular disease, presenting with a massive acute mesenteric ischemia involving multiple intestinal segments. Fluorescence allows two adjusted bowel resections with double intestinal anastomosis. Case 2 is a 74-year-old woman with a history of non-anticoagulated atrial fibrillation who is decided to perform an urgent surgery when an esophageal, gastric and portal system pneumatosis is observed, as indirect signs of ischemia, in urgent CT. During the surgical act there is an ischemia of the terminal ileum and right colon without clear signs of involvement at the esophageal-gastric level. The assessment after administration of ICG discriminates the clear ischemic involvement from terminal ileum to ascending colon and patched in the transverse and left colon, without esophageal or gastric involvement. Case 3 is a 49-year-old woman with aortoiliac and visceral Takayasu disease and revascularization surgery of the celiac trunk. Given the increase in abdominal pain, a new CT scan demonstrates colonic pneumatosis. Urgent laparotomy shows necrosis at the level of the left colon and hypoperfusion of the cecum. The administration of ICG finds a lack of uptake of the entire colon. A subtotal colectomy with ileostomy and mucous fistula is performed. Conclusions: The fluorescence with ICG provides a better visualization of the intestinal vascularization in the AMI, and allows to determine the limits of the affected tissue to perform adjusted resections.

D-dimer as a marker for early diagnosis of acute mesenteric ischemia

2006 ◽  
Vol 117 (4) ◽  
pp. 463-467 ◽  
Author(s):  
Hüseyin Altinyollar ◽  
Mustafa Boyabatli ◽  
Uğur Berberoğlu
Keyword(s):  
Early Diagnosis ◽  
Mesenteric Ischemia ◽  
Acute Mesenteric Ischemia ◽  
D Dimer

scholarly journals Late Vascular Intervention for Acute Mesenteric Ischemia Is Associated with Early Mortality and Extensive Bowel Resection

2021 ◽  
Vol 73 (3) ◽  
pp. 48-49
Author(s):  
Lillian M. Tran ◽  
Elizabeth Andraska ◽  
Rafael Ramos-Jiminez ◽  
Andrew-Paul Deeb ◽  
Natalie Sridharan ◽  
...  
Keyword(s):  
Mesenteric Ischemia ◽  
Bowel Resection ◽  
Acute Mesenteric Ischemia ◽  
Early Mortality ◽  
Vascular Intervention

scholarly journals Case report: direct revascularization in acute mesenteric ischemia by an endovascular approach

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
P. Genzel ◽  
L. C. van Dijk ◽  
H. T. C. Veger ◽  
J. J. Wever ◽  
R. G. S. van Eps ◽  
...  
Keyword(s):  
Case Report ◽  
Mesenteric Ischemia ◽  
Acute Mesenteric Ischemia ◽  
Endovascular Approach

scholarly journals Materials for Production of High and Ultra-High Performance Concrete: Review and Perspective of Possible Novel Materials

Materials ◽  
2021 ◽  
Vol 14 (15) ◽  
pp. 4304
Author(s):  
Markssuel Teixeira Marvila ◽  
Afonso Rangel Garcez de de Azevedo ◽  
Paulo R. de de Matos ◽  
Sergio Neves Monteiro ◽  
Carlos Maurício Fontes Vieira
Keyword(s):  
High Performance ◽  
High Performance Concrete ◽  
Review Article ◽  
Cement Matrix ◽  
Bibliographic Databases ◽  
Future Research ◽  
Chemical Additives ◽  
Ultra High Performance Concrete ◽  
Conventional Concrete ◽  
Essential Components

This review article proposes the identification and basic concepts of materials that might be used for the production of high-performance concrete (HPC) and ultra-high-performance concrete (UHPC). Although other reviews have addressed this topic, the present work differs by presenting relevant aspects on possible materials applied in the production of HPC and UHPC. The main innovation of this review article is to identify the perspectives for new materials that can be considered in the production of novel special concretes. After consulting different bibliographic databases, some information related to ordinary Portland cement (OPC), mineral additions, aggregates, and chemical additives used for the production of HPC and UHPC were highlighted. Relevant information on the application of synthetic and natural fibers is also highlighted in association with a cement matrix of HPC and UHPC, forming composites with properties superior to conventional concrete used in civil construction. The article also presents some relevant characteristics for the application of HPC and UHPC produced with alkali-activated cement, an alternative binder to OPC produced through the reaction between two essential components: precursors and activators. Some information about the main types of precursors, subdivided into materials rich in aluminosilicates and rich in calcium, were also highlighted. Finally, suggestions for future work related to the application of HPC and UHPC are highlighted, guiding future research on this topic.

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