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Acute mesenteric ischaemia

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https://www.readbyqxmd.com/read/29701357/frozen-elephant-trunk-with-e-vita-open-hybrid-prosthesis-for-surgical-correction-of-multisegmental-thoracic-aortic-pathology-review-of-results
#1
António Cruz Tomás, Álvaro Laranjeira Santos, Jorge Pinheiro Santos, Daniela Varela-Afonso, José Fragata
INTRODUCTION: The Frozen Elephant Trunk (FET) surgery allows correction of ascending, arch and proximal descending aortic pathology, using a hybrid prosthesis at the same time. It is a complex intervention and requires a multidisciplinary team that, besides scheduling and performing the surgery, accompanies the patient (pt) throughout the postoperative period. OBJECTIVES: To review short and medium term clinical results with this technique. METHODS: Between January 2010 and September 2017, we operated 34 patients (pts) using FET...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29617826/long-term-outcomes-of-total-arch-replacement-with-the-non-frozen-elephant-trunk-technique-for-stanford-type-a-acute-aortic-dissection
#2
Yosuke Inoue, Hitoshi Matsuda, Atsushi Omura, Yoshimasa Seike, Kyokun Uehara, Hiroaki Sasaki, Junjiro Kobayashi
OBJECTIVES: Arch repair using the frozen elephant trunk (FET) technique has been utilized to treat Type A acute aortic dissection. In contrast, the long-term outcomes of the non-FET technique focus on the thrombosed false lumen (FL), and distal aortic reoperation rates remain unclear. The goal of our study was to investigate the efficacy and long-term outcomes of the non-FET technique as the benchmark. METHODS: We reviewed 518 patients with Type A acute aortic dissection in the last 20 years...
March 29, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29600311/comparison-of-the-diagnostic-values-of-vascular-adhesion-protein-1-and-intestinal-fatty-acid-binding-protein-in-the-diagnosis-of-acute-mesenteric-ischemia
#3
Aynur Sahin, Damla Aydin Altay, Selim Demir, Esin Yulug, Ahmet Menteşe, Ozgur Tatli, Yunus Karaca, Senol Ardic, Abdulkadir Gunduz, Suleyman Turedi
OBJECTIVES: The aim of this study is to compare the diagnostic values of plasma levels of vascular adhesion protein-1 (VAP-1) and intestinal fatty acid-binding protein (I-FABP) for diagnosing acute mesenteric ischemia (AMI). METHODS: The study used a randomized, controlled experimental design. Forty-two female Sprague-Dawley rats were divided into three control groups and three ischemia groups. Plasma VAP-1 and I-FABP levels were measured, and the extent of ischemic damage was determined using a histopathological damage score in terminal ileum tissue samples...
March 29, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29588359/antiphospholipid-syndrome-presenting-as-acute-mesenteric-venous-thrombosis-involving-a-variant-inferior-mesenteric-vein-and-successful-treatment-with-rivaroxaban
#4
Kevin Singh, Gulam Khan
Acute mesenteric venous thrombosis (MVT) is the rarest cause of acute mesenteric ischaemia, so thrombosis of a variant inferior mesenteric vein (IMV) is especially uncommon in the setting of antiphospholipid syndrome (APS). Here, we present such a case of seronegative APS initially manifesting as an anomalous IMV thrombosis in a 76-year-old woman. Although guidelines support anticoagulation with vitamin K antagonists in these patients, we anticoagulated with rivaroxaban (a direct oral anticoagulant (DOAC)) due to patient preference, which resulted in complete clinical and endoscopic resolution...
March 26, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29537132/role-of-super-selective-embolization-in-lower-gastrointestinal-bleeding
#5
Sajith C Senadeera, Simon V Vun, Nicholas Butterfield, Tim W Eglinton, Frank A Frizelle
BACKGROUND: Lower gastrointestinal bleeding (LGIB) is a common acute general surgical condition that is typically self-limiting; however in refractory cases it can necessitate life-saving intervention. When bleeding is refractory, super-selective embolization (SSE) becomes an important management strategy. This study aims to evaluate outcomes of this procedure at our institution and identify predictors of clinical success. METHODS: A retrospective analysis of patients with positive computed tomography angiograms for LGIB at a tertiary centre between December 2007 and May 2017...
March 14, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29515007/clinical-value-of-serum-lactate-measurement-in-diagnosing-acute-mesenteric-ischaemia
#6
C J Isfordink, D Dekker, J F Monkelbaan
Acute mesenteric ischaemia (AMI) is a life-threatening disease with a mortality rate around 60%. This high mortality rate is largely caused by diagnostic delay, which means there is a pressing need for a reliable biomarker. In clinical practice, serum lactate measurement is often used for the diagnosis of AMI. To assess the diagnostic value of serum lactate, we performed a literature search. Lactate has two different isomers. The well-known L-lactate, produced by anaerobic glycolysis, and the more unknown D-lactate which is only produced by intestinal bacteria...
March 2018: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29450690/mortality-rates-of-patients-undergoing-emergency-laparotomy-in-an-irish-university-teaching-hospital
#7
Aoife C Kiernan, Peadar S Waters, Sean Tierney, Paul Neary, Maria Donnelly, Dara O Kavanagh, Bridget Egan
INTRODUCTION: Emergency laparotomy (EL) is a commonly performed operation with increased morbidity and mortality. Currently, there is a lack of published outcomes following emergency laparotomy within an Irish population. The aim of this study was to assess our outcomes and compare these to predefined outcomes from NELA. METHODS: A review of a prospectively maintained database of all patients who underwent an emergency laparotomy between January 1st 2015 and October 31st 2016 was performed...
February 15, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29321203/acute-on-chronic-mesenteric-ischaemia-by-early-and-diffuse-atherosclerosis-in-a-young-adult-patient
#8
Marta Gravito-Soares, Elisa Gravito-Soares, Pedro Figueiredo, Luis Tomé
No abstract text is available yet for this article.
January 9, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29290518/enteral-nutrition-improves-clinical-outcome-and-reduces-costs-of-acute-mesenteric-ischaemia-after-recanalisation-in-the-intensive-care-unit
#9
Shuofei Yang, Jianming Guo, Qihong Ni, Jiaquan Chen, Xiangjiang Guo, Guanhua Xue, Meng Ye, Lan Zhang
BACKGROUND: Little data evaluate the enteral nutrition (EN) for patients with acute mesenteric ischaemia (AMI) in the intensive care unit (ICU). This study assessed the outcomes of EN for recanalised AMI patients in the ICU. METHODS: In this retrospective study, 183 AMI patients with mesenteric recanalisation admitted to two surgical ICUs were included. Patients were divided into EN (EN within first week, n = 95) and total parenteral nutrition (TPN) group (TPN in 1st week, n = 88)...
December 20, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29240055/-endovascular-treatment-of-acute-mesenteric-ischaemia-in-thrombosis-of-superior-mesenteric-artery
#10
A A Shchegolev, S A Papoian, A E Mitichkin, D G Gromov, A G Ishevskiĭ, A Iu Chevokin, M M Mutaev
The article deals with the problems related to acute impairment of mesenteric blood circulation, known as a nosological entity associated with an extremely high mortality rate. The authors point out that there are currently no common approaches to appropriate management of the pathology concerned and define the role of modern minimally invasive methods, which roentgenosurgical interventions belong to, making it possible to rapidly, safely and efficiently cope with the problem of thrombosis of mesenteric vessels, as well as to decrease lethality and improve the prognosis in this cohort of patients...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/29240054/-endovascular-interventions-in-treatment-of-patients-with-acute-impairment-of-mesenteric-blood-circulation
#11
A I Khripun, A V Salikov, A B Mironkov, A D Priamikov
The authors share herein their experience of treating a total of eight patients with acute impairment of mesenteric blood circulation, describing both technical and instrumental peculiarities of interventions on the superior mesenteric artery. Technical success defined as restoration of the main blood flow through the superior mesenteric artery was achieved in seven (87.5%) patients. Of these, two (25%) patients required laparotomy and intestinal resection, with the scope of resection being significantly reduced in one case after endovascular thrombectomy...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/29145109/cisplatin-induced-acute-mesenteric-ischaemia-a-case-report-and-review-of-the-literature
#12
Shivun Khosla, Lauren Kennedy, Yasser Abdulaal
INTRODUCTION: Cisplatin is a platinum-based chemotherapeutic agent, widely used in cancer therapies for numerous solid tumours. It is becoming more recognised that a potentially life-threatening complication of cisplatin is accelerated arterial and venous thrombosis. PRESENTATION OF CASE: We describe a case of a 62year-old with no risk factors for vascular disease who presented with thromboembolic acute mesenteric ischaemia of the small bowel during treatment with cisplatin for head and neck cancer...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29124893/ischaemic-colitis-uncertainty-in-diagnosis-pathophysiology-and-management
#13
REVIEW
Amanda L Nikolic, James O Keck
Ischaemic colitis is the most common form of gastrointestinal ischaemia, but may be confused with acute mesenteric ischaemia, inflammatory bowel disease or infectious colitis. This review article outlines the current classification, epidemiology and risk factors, as well as approaches about diagnosis and management to guide clinical practice. It also identifies areas for further research.
November 9, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28790028/staged-retroperitoneal-mesenteric-revascularisation-and-aortobifemoral-bypass-after-endovascular-rescue-for-acute-mesenteric-ischaemia
#14
Shepard Peir Johnson, Melani Lighter, Harry Linne Anderson, Abdulhameed Aziz
Visceral artery revascularisation through a retroperitoneal approach provides an infrequent yet viable, alternative means of managing mesenteric ischaemia in patients with previous abdominal operations. We present a unique case implementing this surgical approach in a 55-year-old man in which we performed a retroperitoneal aortobifemoral bypass with concomitant retrograde jump graft from the aortic prosthesis to the superior mesenteric artery (SMA) for bilateral lower extremity rest pain and chronic mesenteric ischaemia...
August 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28553765/short-interval-postconditioning-protects-the-bowel-against-ischaemia-reperfusion-injury-in-rats
#15
Sezen Ozkisacik, Ali Onur Erdem, Barlas Etensel, Canten Tataroglu, Mukadder Serter, Mesut Yazici
Objective Acute mesenteric ischaemia leads to intestinal damage. Restoration of blood flow results in further damage to tissue, which is called reperfusion injury. This study aimed to investigate the protective effects of short-interval postconditioning and to determine the optimal interval for reperfusion in an experimental rat model of intestinal ischaemia. Methods Forty adult male Wistar rats were grouped as follows: sham (Sh), ischaemia + reperfusion (IR), ischaemia + postconditioning for 5 seconds (PC5), ischaemia + postconditioning for 10 seconds (PC10), and ischaemia + postconditioning for 20 seconds (PC20)...
June 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28495543/trans-pericardal-color-doppler-ultra-sound-to-assess-blood-flow-in-the-visceral-branches-during-type-a-dissection-procedures-complicated-with-mesenteric-malperfusion
#16
Luigi Muzzi, Giulio Tommasino, Giulia Guaccio, Enrico Tucci, Franco Roviello, Eugenio Neri
Aortic dissection is a complex disease associated with high mortality and morbidity. Among the different possible clinical presentations, type A aortic dissection complicated at the onset by mesenteric malperfusion is characterized by poor outcome compared with patients not presenting such complication. We report the case of a patient with acute type A aortic dissection presenting with mesenteric malperfusion, in whom trans-pericardial color Doppler ultrasound (CDUS) examination was used to assess intraoperative and postoperative blood flow in the mesenteric artery...
October 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28395781/pharmacological-secondary-prevention-in-patients-with-mesenterial-artery-atherosclerosis-and-arterial-embolism
#17
REVIEW
Anders Gottsäter
Visceral arteries such as the coeliac (CA), superior mesenteric (SMA), and the inferior mesenteric artery (IMA) might be affected by atherosclerotic occlusive lesions with or without thrombosis or embolization causing ischaemic symptoms from the gastrointestinal tract. After treatment of an acute event, these patients should be offered both non-pharmacological and pharmacological secondary prevention to reduce risk for future ischaemic arterial manifestations. Patients with mesenteric ischaemia caused by atherosclerosis should be evaluated concerning platelet antiaggregation with low dose aspirin or clopidogrel, and those with cardioembolic disease should be recommended anticoagulant treatment with either warfarin or one of the direct oral anticoagulants (DOAC; apixaban, dabigatran, edoxaban, or rivaroxaban)...
February 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28338117/endovascular-treatment-for-acute-mesenteric-ischaemia-in-a-young-woman-with-polyarterial-disease
#18
Mihai C Ober, Calin Homorodean, Dan A Tataru, Antonia E Macarie, Camelia D Ober, Dan M Olinic
BACKGROUND: Acute mesenteric ischaemia is a condition with a grim prognosis on conservative treatment. Endovascular revascularisation is a promising approach for some of these patients. CASE REPORT: We present the case of a 44-year-old woman with a history of severe arterial hypertension, left leg claudication, and overlooked symptoms of chronic mesenteric ischaemia for one year, who was admitted for severe abdominal pain for one week. Computed tomographic angiography (CTA) showed acute mesenteric ischaemia by occlusion of the coeliac trunk and the superior mesenteric artery (SMA), without bowel perforation...
March 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28254161/long-term-results-of-endovascular-treatment-of-atherosclerotic-stenoses-or-occlusions-of-the-coeliac-and-superior-mesenteric-artery-in-patients-with-mesenteric-ischaemia
#19
T Bulut, R Oosterhof-Berktas, R H Geelkerken, M Brusse-Keizer, E J Stassen, J J Kolkman
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/or CT angiography...
April 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28224105/nutrient-stimulation-of-mesenteric-blood-flow-implications-for-older-critically-ill-patients
#20
REVIEW
Thu An Nguyen, Yasmine Ali Abdelhamid, Liza K Phillips, Leeanne S Chapple, Michael Horowitz, Karen L Jones, Adam M Deane
Nutrient ingestion induces a substantial increase in mesenteric blood flow. In older persons (aged ≥ 65 years), particularly those with chronic medical conditions, the cardiovascular compensatory response may be inadequate to maintain systemic blood pressure during mesenteric blood pooling, leading to postprandial hypotension. In older ambulatory persons, postprandial hypotension is an important pathophysiological condition associated with an increased propensity for syncope, falls, coronary vascular events, stroke and death...
February 4, 2017: World Journal of Critical Care Medicine
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