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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 2/2016

01-02-2016 | Clinical Investigation

Endovascular Management of Acute Embolic Occlusion of the Superior Mesenteric Artery: A 12-Year Single-Centre Experience

Authors: J. Raupach, M. Lojik, V. Chovanec, O. Renc, M. Strýček, P. Dvořák, P. Hoffmann, I. Guňka, A. Ferko, P. Ryška, N. Omran, A. Krajina, P. Čabelková, E. Čermáková, R. Malý

Published in: CardioVascular and Interventional Radiology | Issue 2/2016

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Abstract

Purpose

Retrospective evaluation of 12-year experience with endovascular management of acute mesenteric ischemia (AMI) due to embolic occlusion of the superior mesenteric artery (SMA).

Materials and methods

From 2003 to 2014, we analysed the in-hospital mortality of 37 patients with acute mesenteric embolism who underwent primary endovascular therapy with subsequent on-demand laparotomy. Transcatheter embolus aspiration was used in all 37 patients (19 women, 18 men, median age 76 years) with embolic occlusion of the SMA. Adjunctive local thrombolysis (n = 2) and stenting (n = 2) were also utilised.

Results

We achieved complete recanalization of the SMA stem in 91.9 %. One patient was successfully treated by surgical embolectomy due to a failed endovascular approach. Subsequent exploratory laparotomy was performed in 73.0 % (n = 27), and necrotic bowel resection in 40.5 %. The total in-hospital mortality was 27.0 %.

Conclusion

Primary endovascular therapy for acute embolic SMA occlusion with on-demand laparotomy is a recommended algorithm used in our centre to treat SMA occlusion. This combined approach for the treatment of AMI is associated with in-hospital mortality rate of 27.0 %.
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Metadata
Title
Endovascular Management of Acute Embolic Occlusion of the Superior Mesenteric Artery: A 12-Year Single-Centre Experience
Authors
J. Raupach
M. Lojik
V. Chovanec
O. Renc
M. Strýček
P. Dvořák
P. Hoffmann
I. Guňka
A. Ferko
P. Ryška
N. Omran
A. Krajina
P. Čabelková
E. Čermáková
R. Malý
Publication date
01-02-2016
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 2/2016
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-015-1156-6

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