The role of endovascular therapy in acute mesenteric ischemia (original) (raw)

Abstract

Background Endovascular therapy, including aspiration thrombectomy and local thrombolytic therapy, often associated with angioplasty and stent placement, has been described in the literature. The purpose of this study was to review case series of patients with acute mesenteric ischemia treated with endovascular therapy and evaluate their outcomes. Methods An online review using PubMed was carried out to identify all English articles about this topic in the time interval from 2005 to 2016. The following variables were extracted: number of patients, cause of occlusion, symptoms, arteries involved, number of sessions of treatment, technical success, clinical success, recurrence rate, complications, mortality rate, number of patients who underwent diagnostic laparoscopy or surgical resection of ischemic bowel. Results Eighteen papers met the inclusion criteria and were included. Among the patients with arterial mesenteric ischemia treated with endovascular approach, the technical success rate was high (up to 100%) and data regarding clinical success are encouraging, even though they are few and heterogeneous. Technical success rate and clinical success of patients with acute venous mesenteric ischemia approached with endovascular treatment was 74-100% and 87.5-100% respectively. Conclusions Current advances in endovascular therapies have made these treatments feasible for mesenteric ischemia.

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References (41)

  1. Resch T, Lindh M, Dias N, et al. Endovascular recanalisation in occlusive mesenteric ischemia-feasibility and early results. Eur J Vasc Endovasc Surg 2005;29:199-203.
  2. Lim RP, Dowling RJ, Mitchell PJ, Vrazas JI, Thomson KR, Tress BM. Endovascular treatment of arterial mesenteric ischaemia: a retrospective review. Australas Radiol 2005;49:467-475.
  3. Wyers MC, Powell RJ, Nolan BW, Cronenwett JL. Retrograde mesenteric stenting during laparotomy for acute occlusive mesenteric ischemia. J Vasc Surg 2007;45:269-275.
  4. Acosta S, Sonesson B, Resch T. Endovascular therapeutic approaches for acute superior mesenteric artery occlusion. Cardiovasc Intervent Radiol 2009;32:896-905.
  5. Schermerhorn ML, Giles KA, Hamdan AD, Wyers MC, Pomposelli FB. Mesenteric revascularization: management and outcomes in the United States, 1988-2006. J Vasc Surg 2009;50:341-348.
  6. Block TA, Acosta S, Björck M. Endovascular and open surgery for acute occlusion of the superior mesenteric artery. J Vasc Surg 2010;52:959-966.
  7. Björnsson S, Björck M, Block T, Resch T, Acosta S. Thrombolysis for acute occlusion of the superior mesenteric artery. J Vasc Surg 2011;54:1734-1742.
  8. Arthurs ZM, Titus J, Bannazadeh M, et al. A comparison of endovascular revascularization with traditional therapy for the treatment of acute mesenteric ischemia. J Vasc Surg 2011;53:698-704.
  9. Ryer EJ, Kalra M, Oderich GS, et al. Revascularization for acute mesenteric ischemia. J Vasc Surg 2012;55:1682-1689.
  10. Beaulieu RJ, Arnaoutakis KD, Abularrage CJ, Efron DT, Schneider E, Black JH 3 rd . Comparison of open and endovascular treatment of acute mesenteric ischemia. J Vasc Surg 2014;59:159-164.
  11. Jia Z, Jiang G, Tian F, et al. Early endovascular treatment of superior mesenteric occlusion secondary to thromboemboli. Eur J Vasc Endovasc Surg 2014;47:196-203.
  12. Serracant Barrera A, Luna Aufroy A, Hidalgo Rosas JM, et al. Acute mesenteric ischemia: Utility of endovascular techniques. Cir Esp 2015;93:567-572.
  13. Kärkkäinen JM, Lehtimäki TT, Saari P, et al. Endovascular therapy as primary revascularization modality in acute mesenteric ischemia. Cardiovasc Intervent Radiol 2015;38:1119-1129.
  14. Raupach J, Lojik M, Chovanec V, et al. Endovascular management of acute embolic occlusion of the superior mesenteric artery: a 12-year single-centre experience. Cardiovasc Intervent Radiol 2016;39:195-203.
  15. Yang S, Liu B, Ding W, He C, Wu X, Li J. Acute superior mesenteric venous thrombosis: transcatheter thrombolysis and aspiration thrombectomy therapy by combined route of superior mesenteric vein and artery in eight patients. Cardiovasc Intervent Radiol 2015;38:88-99.
  16. Liu FY, Wang MQ, Fan QS, Duan F, Wang ZJ, Song P. Interventional treatment for symptomatic acute-subacute portal and superior mesenteric vein thrombosis. World J Gastroenterol 2009;15:5028-5034.
  17. Wang MQ, Liu FY, Duan F, Wang ZJ, Song P, Fan QS. Acute symptomatic mesenteric venous thrombosis: treatment by catheter- directed thrombolysis with transjugular intrahepatic route. Abdom Imaging 2011;36:390-398.
  18. Wichman HJ, Cwikiel W, Keussen I. Interventional treatment of mesenteric venous occlusion. Pol J Radiol 2014;79:233-238.
  19. Yang SF, Liu BC, Ding WW, He CS, Wu XJ, Li JS. Initial transcatheter thrombolysis for acute superior mesenteric venous thrombosis. World J Gastroenterol 2014;20:5483-5492.
  20. Yang S, Fan X, Ding W, et al. Multidisciplinary stepwise management strategy for acute superior mesenteric venous thrombosis: an intestinal stroke center experience. Thromb Res 2015;135:36-45.
  21. Oldenburg WA, Lau LL, Rodenberg TJ, Edmonds HJ, Burger CD. Acute mesenteric ischemia: a clinical review. Arch Intern Med 2004;164:1054-1062.
  22. Singal AK, Kamath PS, Tefferi A. Mesenteric venous thrombosis. Mayo Clin Proc 2013;88:285-294.
  23. Kuhelj D, Kavcic P, Popovic P. Percutaneous mechanical thrombectomy of superior mesenteric artery embolism. Radiol Oncol 2013;47:239-243.
  24. Popovič P, Kuhelj D, Bunc M. Superior mesenteric artery embolism treated with percutaneous mechanical thrombectomy. Cardiovasc Intervent Radiol 2011;34 Suppl 2:S67-S69.
  25. Sternbergh WC 3 rd , Ramee SR, DeVun DA, Money SR. Endovascular treatment of multiple visceral artery paradoxical emboli with mechanical and pharmacological thrombolysis. J Endovasc Ther 2000;7:155-160.
  26. Ballehaninna UK, Hingorani A, Ascher E, et al. Acute superior mesenteric artery embolism: reperfusion with AngioJet hydrodynamic suction thrombectomy and pharmacologic thrombolysis with the EKOS catheter. Vascular 2012;20:166-169.
  27. Zeleňák K, Sinák I, Janík J, Mikolajčík A, Mištuna D. Successful recanalization of acute superior mesenteric artery thromboembolic occlusion by a combination of intraarterial thrombolysis and mechanical thrombectomy with a carotid filter. Cardiovasc Intervent Radiol 2013;36:844-847.
  28. Yang HJ, Cho YK, Jo YJ, Jung YY, Choi SA, Lee SH. Successful recanalization of acute superior mesenteric artery thrombotic occlusion with primary aspiration thrombectomy. World J Gastroenterol 2010;16:4112-4114.
  29. Heiss P, Zorger N, Kaempfe I, et al. [Stenting in the treatment of chronic mesenteric ischemia: technical and clinical success rates]. Rofo 2008;180:906-914.
  30. Kawasaki R, Miyamoto N, Oki H, et al. Aspiration therapy for acute superior mesenteric artery embolism with an angled guiding sheath and guiding catheter. J Vasc Interv Radiol 2014;25:635-639.
  31. Kawarada O, Sonomura T, Yokoi Y. Direct aspiration using rapid- exchange and low-profile device for acute thrombo-embolic occlusion of the superior mesenteric artery. Catheter Cardiovasc Interv 2006;68:862-866.
  32. Nishida A, Fukui K. Images in clinical medicine. Transcatheter treatment of thromboembolism in the superior mesenteric artery. N Engl J Med 2005;353:e4.
  33. Demirpolat G, Oran I, Tamsel S, Parildar M, Memis A. Acute mesenteric ischemia: endovascular therapy. Abdom Imaging 2007;32:299-303.
  34. Gartenschlaeger S, Bender S, Maeurer J, Schroeder RJ. Successful percutaneous transluminal angioplasty and stenting in acute mesenteric ischemia. Cardiovasc Intervent Radiol 2008;31:398-400.
  35. Moyes LH, McCarter DH, Vass DG, Orr DJ. Intraoperative retrograde mesenteric angioplasty for acute occlusive mesenteric ischaemia: a case series. Eur J Vasc Endovasc Surg 2008;36:203-206.
  36. Branco BC, Montero-Baker MF, Aziz H, Taylor Z, Mills JL. Endovascular therapy for acute mesenteric ischemia: an NSQIP analysis. Am Surg 2015;81:1170-1176.
  37. Heiss P, Loewenhardt B, Manke C, et al. Primary percutaneous aspiration and thrombolysis for the treatment of acute embolic superior mesenteric artery occlusion. Eur Radiol 2010;20:2948-2958.
  38. Morasch MD, Ebaugh JL, Chiou AC, Matsumura JS, Pearce WH, Yao JS. Mesenteric venous thrombosis: a changing clinical entity. J Vasc Surg 2001;34:680-684.
  39. Brunaud L, Antunes L, Collinet-Adler S, et al. Acute mesenteric venous thrombosis: case for nonoperative management. J Vasc Surg 2001;34:673-679.
  40. Bergqvist D, Svensson PJ. Treatment of mesenteric vein thrombosis. Semin Vasc Surg 2010;23:65-68.
  41. Zhao Y, Yin H, Yao C, et al. Management of acute mesenteric ischemia: a critical review and treatment algorithm. Vasc Endovascular Surg 2016;50:183-192.