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

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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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Acknowledgments

Corresponding author Jan Raupach declares: that he did not receive payment or services from a third party (government, commercial, private foundation, etc.) for any aspect of the submitted work (including but not limited to grants, data monitoring board, study design, manuscript preparation, statistical analysis, etc.). He does not have financial relationships (regardless of amount of compensation) with entities as described in the instructions. He does not have any patents, whether planned, pending, or issued, broadly relevant to the work. He confirmed that we he does not have any no other relationships/conditions/circumstances that present a potential conflict of interest. All the authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine at Charles University and University Hospital, Sokolska Street, Hradec Kralove, Czech Republic

    J. Raupach, M. Lojik, V. Chovanec, O. Renc, P. Dvořák, P. Hoffmann, P. Ryška, A. Krajina & P. Čabelková

  2. Faculty of Medicine at Charles University, Hradec Kralove, Czech Republic

    M. Strýček

  3. Department of Surgery, Faculty of Medicine at Charles University and University Hospital, Hradec Kralove, Czech Republic

    I. Guňka & A. Ferko

  4. Department of Cardiac Surgery, Faculty of Medicine at Charles University and University Hospital, Hradec Kralove, Czech Republic

    N. Omran

  5. Computer Technology Center, Faculty of Medicine at Charles University, Hradec Kralove, Czech Republic

    E. Čermáková

  6. Department of Medicine, Faculty of Medicine at Charles University and University Hospital, Hradec Kralove, Czech Republic

    R. Malý

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  1. J. Raupach
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  2. M. Lojik
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  3. V. Chovanec
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  4. O. Renc
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  6. P. Dvořák
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  8. I. Guňka
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  9. A. Ferko
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  10. P. Ryška
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  12. A. Krajina
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  14. E. Čermáková
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Correspondence to J. Raupach.

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Statement of Human and Animal Rights and Informed Consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This work was carried out with the approval of the local ethics committee. For this type of study, formal consent is not required. Informed consent was obtained from all individual participants included in the study.

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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 39, 195–203 (2016). https://doi.org/10.1007/s00270-015-1156-6

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  • DOI: https://doi.org/10.1007/s00270-015-1156-6

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