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Acute Mesenteric Ischemia

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The role of endovascular therapy in acute mesenteric ischemia.
Anna Maria Ierardi ,Dimitrios Tsetis , Sara Sbaraini, Salvatore Alessio Angileri, Nikolaos Galanakis, Mario Petrillo, Francesca Patella, Silvia Panella, Federica Balestra, Natalie Lucchina, and Gianpaolo Carrafielloa
Ann Gastroenterol. 2017; 30(5): 526–533

Rationale for inclusion: This is an online review using PubMed that identified 18 articles from 2005 to 2016. Patients with arterial mesenteric ischemia treated with endovascular approach, the technical success rate was high (up to 100%). 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.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Acute mesenteric ischemia: current multidisciplinary approach.
Savlania A, Tripathi RK
J Cardiovasc Surg (Torino). 2017 Apr;58(2):339-350. doi: 10.23736/S0021-9509.16.09751-2. Epub 2016 Nov 30

Rationale for inclusion: This review article describes and discusses the mechanisms of acute mesenteric ischemia (AMI) and the rationale of currently available endovascular and open surgical techniques in its management. It also includes an algorithm to support the current multidisciplinary approach in decision-making for mesenteric revascularization to manage this high-risk entity.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Outcome of acute mesenteric ischemia in the intensive care unit: a retrospective, multicenter study of 780 cases.
Leone M, Bechis C, Baumstarck K, Ouattara A, Collange O, Augustin P, Annane D, Arbelot C, Asehnoune K, Baldési O, Bourcier S, Delapierre L, Demory D, Hengy B, Ichai C, Kipnis E, Brasdefer E, Lasocki S, Legrand M, Mimoz O, Rimmelé T, Aliane J, Bertrand PM, Bruder N, Klasen F, Friou E, Lévy B, Martinez O, Peytel E, Piton A, Richter E, Toufik K, Vogler MC, Wallet F, Boufi M, Allaouchiche B, Constantin JM, Martin C, Jaber S, Lefrant JY.
Intensive Care Med. 2015 Apr;41(4):667-76.

Rationale for inclusion: This study is a multi-center, retrospective study conducted in 43 French intensive care units, 38 of which were public hospitals. The authors identified 780 patients with acute mesenteric ischemia with 58% of those patients not surviving to ICU discharge. Multiple patient characteristics were more common in non-survivors (older age, presence of cancer, shock, and higher lactates; to name a few).

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Risk of arterial thrombotic events in inflammatory bowel disease.
Ha C, Magowan S, Accortt NA, Chen J, Stone CD.
Am J Gastroenterol. 2009 Jun;104(6):1445-51.

Rationale for inclusion: This paper explores the relationship between inflammatory bowel disease and acute mesenteric ischemia by utilizing a large administrative database. The authors found a significantly higher risk of acute thrombotic intestinal events in patient with inflammatory bowel disease as compared to controls.

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Evaluation of acute mesenteric ischemia: accuracy of biphasic mesenteric multi-detector CT angiography.
Aschoff AJ, Stuber G, Becker BW, Hoffmann MH, Schmitz BL, Schelzig H, Jaeckle T.
Abdom Imaging. 2009 May-Jun;34(3):345-57.

Rationale for inclusion: This study examines 79 patients with acute mesenteric ischemia and essentially validates multi-detector row helical computed tomography as an accurate and rapid diagnostic tool.

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Identification of risk factors for perioperative mortality in acute mesenteric ischemia.
Acosta-Merida MA, Marchena-Gomez J, Hemmersbach-Miller M, Roque-Castellano C, Hernandez-Romero JM.
World J Surg. 2006 Aug;30(8):1579-85.

Rationale for inclusion: This is a retrospective study over a 10-year period that examines 132 patients undergoing operative therapy for acute mesenteric ischemia that identifies predictors of perioperative mortality.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Bedside diagnostic minilaparoscopy in the intensive care patient.
Gagné DJ, Malay MB, Hogle NJ, Fowler DL.
Surgery. 2002 May;131(5):491-6.

Rationale for inclusion: This paper represents one of the initial descriptions of bedside laparoscopy in the intensive care unit for the identification of intestinal and intra-abdominal pathologies in the patient with acidosis, abdominal pain, and suspected mesenteric ischemia.

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Portomesenteric vein gas: pathologic mechanisms, CT findings, and prognosis.
Sebastià C, Quiroga S, Espin E, Boyé R, Alvarez-Castells A, Armengol M.
Radiographics. 2000 Sep-Oct;20(5):1213-24; discussion 1224-6.

Rationale for inclusion: This paper delves into the common imaging finding of portomesenteric gas and explores the different etiologies contributing to this finding. The paper itself has many informative figures exploring portal venous gas, pneumobilia, pneumatosis intestinalis, and pylephlebitis.

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Acute mesenteric ischemia caused by spontaneous isolated dissection of the superior mesenteric artery: treatment by percutaneous stent placement.
Leung DA, Schneider E, Kubik-Huch R, Marincek B, Pfammatter T.
Eur Radiol. 2000;10(12):1916-9.

Rationale for inclusion: This case report is likely the first published experience of completely percutaneous stenting of the superior mesenteric artery for a flow-limiting dissection.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Long-term results after surgery for acute mesenteric ischemia.
Klempnauer J, Grothues F, Bektas H, Pichlmayr R.
Surgery. 1997 Mar;121(3):239-43.

Rationale for inclusion: This work is unique in its assessment of long-term outcomes after surgical intervention for acute mesenteric ischemia (AMI). Similar to other critical vascular pathologies involving tissue loss, the authors find the 5-year survival rate after surgical intervention for AMI is 50%.

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Acute mesenteric ischemia: improved results--a retrospective analysis of ninety-two patients.
Levy PJ, Krausz MM, Manny J.
Surgery. 1990 Apr;107(4):372-80.

Rationale for inclusion: The authors of this study compare a historic cohort of patients undergoing only bowel resection and anastomosis for acute mesenteric ischemia to a more modern cohort of patients that underwent bowel resection with varying patients receiving revascularization, second-look procedures, and delayed anastomosis creation with improved survival in the latter group. The authors also propose an algorithm for the management of patients with acute mesenteric ischemia.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

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