Clinical management of chronic mesenteric ischemia

Published on Mar 1, 2019in United European gastroenterology journal3.549
· DOI :10.1177/2050640618817698
Louisa J.D. van Dijk4
Estimated H-index: 4
(EUR: Erasmus University Rotterdam),
Désirée van Noord9
Estimated H-index: 9
(EUR: Erasmus University Rotterdam)
+ 5 AuthorsMarco J. Bruno67
Estimated H-index: 67
(EUR: Erasmus University Rotterdam)
This This Dutch Mesenteric Ischemia Study group consists of: Ron Balm, Academic Medical Center, Amsterdam Gert Jan de Borst, University Medical Center Utrecht, Utrecht Juliette T Blauw, Medisch Spe...
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#1Louisa van de Loo van Dijk (Erasmus University Medical Center)H-Index: 1
#2Leon M G Moons (UU: Utrecht University)H-Index: 21
Last. Ellen V. Rouwet (Erasmus University Medical Center)H-Index: 20
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Abstract Objective An isolated stenosis of the celiac artery (CA) or the superior mesenteric artery (SMA) is frequently detected in patients with abdominal complaints. The dilemma is whether these patients suffer from chronic mesenteric ischemia (CMI) and whether they will benefit from revascularization. We evaluated the long-term clinical success rates for single CA or SMA revascularization in patients with gastrointestinal symptoms and confirmed mucosal ischemia. Methods This was a retrospecti...
10 CitationsSource
#1Louisa van de Loo van Dijk (EUR: Erasmus University Rotterdam)H-Index: 2
#2Twan van der Wel (EUR: Erasmus University Rotterdam)H-Index: 1
Last. Marco J. Bruno (EUR: Erasmus University Rotterdam)H-Index: 67
view all 8 authors...
Background: Visible light spectroscopy (VLS) performed during upper gastrointestinal endoscopy allows measuring mucosal oxygen saturation levels to determine gastrointestinal ischemia. We a...
3 CitationsSource
#1Young Erben (Yale University)H-Index: 15
#2Raymond A. Jean (Yale University)H-Index: 12
Last. Bauer E. Sumpio (Yale University)H-Index: 77
view all 8 authors...
Abstract Objective Chronic mesenteric ischemia (CMI) continues to be a devastating diagnosis. There is a national trend toward increased use of endovascular procedures with improved survival for the treatment of these patients. Our aim was to evaluate whether this trend has changed CMI patients' length of hospitalization and health care cost. Methods We identified all patients admitted for CMI from the National Inpatient Sample (NIS) from 2000 to 2014. Our primary end points included length of h...
10 CitationsSource
#1Fares Alahdab (Mayo Clinic)H-Index: 46
#2Remy Arwani (Ain Shams University)H-Index: 1
Last. M. Hassan Murad (Mayo Clinic)H-Index: 88
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Abstract Background Despite the enthusiasm for endovascular revascularization for chronic mesenteric ischemia (CMI), it is not clear if early benefits offset long-term patency rates. This systematic review aimed to provide an up-to-date comprehensive evidence synthesis evaluating the two approaches. Methods We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus through July 15, 2016, for studies that compared the endovascu...
30 CitationsSource
#1Anil K. Pillai (University of Texas Health Science Center at Houston)H-Index: 11
#2Sanjeeva P. Kalva (UTSW: University of Texas Southwestern Medical Center)H-Index: 41
Last. Jeffrey L. WeinsteinH-Index: 9
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#1Sara L. Zettervall (BIDMC: Beth Israel Deaconess Medical Center)H-Index: 19
#2Ruby C. Lo (BIDMC: Beth Israel Deaconess Medical Center)H-Index: 15
Last. Marc L. Schermerhorn (BIDMC: Beth Israel Deaconess Medical Center)H-Index: 61
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Background It is unknown whether increased endovascular treatment of chronic mesenteric ischemia has led to decreases in open surgery, acute mesenteric ischemia, or overall mortality. The present study evaluates the trends in endovascular and open treatment over time for chronic and acute mesenteric ischemia. Methods We identified patients with chronic or acute mesenteric ischemia in the Nationwide Inpatient Sample and Center for Disease Control and Prevention database from 2000 to 2012. Trends ...
32 CitationsSource
#1Nicholas Fidelman (UCSF: University of California, San Francisco)H-Index: 21
#2Ali F. AbuRahma (WVU: West Virginia University)H-Index: 34
Last. Jonathan M. Lorenz (U of C: University of Chicago)H-Index: 25
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Abstract Mesenteric vascular insufficiency is a serious medical condition that may lead to bowel infarction, morbidity, and mortality that may approach 50%. Recommended therapy for acute mesenteric ischemia includes aspiration embolectomy, transcatheter thrombolysis, and angioplasty with or without stenting for the treatment of underlying arterial stenosis. Nonocclusive mesenteric ischemia may respond to transarterial infusion of vasodilators such as nitroglycerin, papaverine, glucagon, and pros...
18 CitationsSource
Dedication These guidelines are dedicated to Paola De Rango, University of Perugia, Italy. She participated very actively in the process of developing these guidelines, in particular the important chapters on chronic arterial and venous mesenteric ischaemia. Six days after the second meeting of the task force she died unexpectedly, to our great despair and loss. We honour her dedication and scientific integrity by completing these guidelines. Among many other commitments she was a very productiv...
186 CitationsSource
#1Tomas Bulut (Medisch Spectrum Twente)H-Index: 2
#2R. Oosterhof-Berktas (Medisch Spectrum Twente)H-Index: 1
Last. Jeroen J. Kolkman (Medisch Spectrum Twente)H-Index: 28
view all 6 authors...
Introduction Over the past decade, primary percutaneous mesenteric artery stenting (PMAS) has become an alternative to open revascularisation for treatment of mesenteric ischaemia. Institutes have presented favourable short-term outcomes after PMAS, but there is a lack of data on long-term stent patency. Methods One hundred and forty-one patients treated by PMAS for acute and chronic mesenteric ischaemia over an 8 year period were studied. Anatomical success was assessed by duplex ultrasound and...
18 CitationsSource
#1Louisa J.D. van Dijk (Erasmus University Medical Center)H-Index: 4
Last. Adriaan Moelker (Erasmus University Medical Center)H-Index: 27
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Imaging of the mesenteric vasculature is crucial in diagnosing vascular disease of the gastro-intestinal tract such as acute or chronic mesenteric ischemia caused by arterial stenosis, embolism or thrombosis, mesenteric vein thrombosis and mesenteric aneurysm or dissection. The reference standard for imaging of the mesenteric vasculature is digital subtraction angiography. However, modalities as duplex ultrasonography, computed tomography angiography and magnetic resonance angiography are develo...
8 CitationsSource
Cited By18
#1Kristofor A. Olson (University of Texas at Austin)H-Index: 5
#2Pedro G.R. Teixeira (University of Texas at Austin)H-Index: 43
#1Luke G. Terlouw (EUR: Erasmus University Rotterdam)H-Index: 2
Last. Marco J. Bruno (EUR: Erasmus University Rotterdam)H-Index: 67
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BACKGROUND The mesenteric artery calcium score (MACS) identifies patients with possible chronic mesenteric ischaemia (CMI) using standard computed tomography (CT) imaging. The MACS does not necessitate a dedicated computed tomography angiography (CTA) which is required for evaluation of mesenteric artery patency. This study aimed to test the use of a symptom and MACS based score chart to facilitate the selection of patients with a low probability of CMI, in whom further diagnostic workup can be ...
#1Luke G. Terlouw (EUR: Erasmus University Rotterdam)H-Index: 2
Last. Adriaan Moelker (EUR: Erasmus University Rotterdam)H-Index: 27
view all 5 authors...
A practical screening tool for chronic mesenteric ischemia (CMI) could facilitate early recognition and reduce undertreatment and diagnostic delay. This study explored the ability to discriminate CMI from non-CMI patients with a mesenteric artery calcium score (MACS). This retrospective study included CTAs of consecutive patients with suspected CMI in a tertiary referral center between April 2016 and October 2019. A custom-built software module, using the Agatston definition, was developed and u...
1 CitationsSource
#1Naiding Zhang (ZJU: Zhejiang University)
#2Changming Shao (ZJU: Zhejiang University)
Last. Bing Chen (ZJU: Zhejiang University)
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Multiple spontaneous visceral arterial dissections are an infrequent occurrence. The etiology, risk factors and natural history of these dissections have not been elucidated, and the optimal therapeutic strategy has not been established. We report a rare case of multiple spontaneous visceral arterial dissections involving the celiac artery, splenic artery, superior mesenteric artery, and right renal artery in a patient with Tolosa-Hunt syndrome on short-term corticosteroid therapy. The patient w...
#1G. Jay Bishop (Cleveland Clinic)H-Index: 2
#2Sean P. Lyden (Cleveland Clinic)H-Index: 36
Last. Elizabeth V Ratchford (JHUSOM: Johns Hopkins University School of Medicine)H-Index: 11
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Abstract Background Chronic mesenteric ischemia results from the inability to achieve adequate postprandial intestinal blood flow, usually from atherosclerotic occlusive disease at the origins of the mesenteric vessels. Patients typically present with postprandial pain, food fear and weight loss although they can present with acute mesenteric ischemia and bowel infarction. The diagnosis requires the combination of the appropriate clinical symptoms and significant mesenteric artery occlusive dise...
4 CitationsSource
#1Nikhil Parimi (KU: University of Kansas)
#2Matthew Lippmann (KU: University of Kansas)H-Index: 2
Last. Jesse Richards (KU: University of Kansas)H-Index: 1
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Chronic mesenteric ischemia until now represent the difficult tasks of primary diagnosis and ambiguous approaches to therapy. This review analyzes domestic and foreign research articles from the PubMed database, the eLibrary scientifi c digital library over the past decades. A review of literary sources allowed to provide modern data on the epidemiology, diagnosis and treatment of chronic mesenteric ischemia from the standpoint of evidence-based medicine.
INTRODUCTION: This study aimed to determine the incidence of chronic mesenteric ischemia (CMI) and to examine the influence of the etiological cause, location, and severity of a mesenteric artery stenosis on the probability of having CMI. METHODS: A prospective database, containing the details of all patients with suspected CMI referred to a renowned CMI expert center, was used. Patients residing within the expert centers’ well-defined region, between January 2014 and October 2019, were included...
3 CitationsSource