Is acute mesenteric ischemia incurable situation? The current state of the problem

Pankratov A.A.; Perehodov S.N.; Zelenin D.A.; Izrailov R.E.; Matkov I.V.

doi:https://doi.org/10.17116/hirurgia2020121105

Pankratov A.A.

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov;
City Clinical Hospital named after V.P. Demihov of the Moscow City Health Department

Perehodov S.N.

City Clinical Hospital named after V.P. Demihov of the Moscow City Health Department

Zelenin D.A.

City Clinical Hospital named after V.P. Demihov of the Moscow City Health Department

Izrailov R.E.

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

SPIN RSCI: 7121-2776
Scopus AuthorID: 56571607000
ORCID: 0000-0001-7254-5411

Matkov I.V.

City Clinical Hospital named after V.P. Demihov of the Moscow City Health Department

Is acute mesenteric ischemia incurable situation? The current state of the problem

Authors:

Pankratov A.A., Perehodov S.N., Zelenin D.A., Izrailov R.E., Matkov I.V.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2020;(12): 105‑110

DOI: 10.17116/hirurgia2020121105

Read: 7284 times

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Pankratov AA, Perehodov SN, Zelenin DA, Izrailov RE, Matkov IV. Is acute mesenteric ischemia incurable situation? The current state of the problem. Pirogov Russian Journal of Surgery. 2020;(12):105‑110. (In Russ.)
https://doi.org/10.17116/hirurgia2020121105

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

Close metadata

Recommended articles:

Endovascular treatment and selection criteria for acute mesenteric ischemia. Pirogov Russian Journal of Surgery. 2025;(2):13-19

The first Russian experience of pediatric subtotal facial tissue replantation. Plastic Surgery and Aesthetic Medicine. 2024;(4):5-15

Characteristics, treatment features and in-hospital mortality of patients with myocardial infarction over 75 years old in Russia according to the REGION-IM registry. Russian Cardiology Bulletin. 2025;(1):22-38

Topographic and anatomical features of cranial bones in patients with classical trigeminal neuralgia. Russian Journal of Pain. 2025;(3):33-41

Double extra-intracranial microvascular anastomoses in deconstructive surgeries for giant aneurysms of internal carotid and middle cerebral arteries. Burdenko's Journal of Neurosurgery. 2025;(5):16-27

Abstract:

Mortality rates in acute mesenteric ischemia remain at an extremely high level for many decades. Early diagnosis and selection of the optimal method of revascularization are among the ways to optimize tactics. The diagnostic study of choice is CT angiography. Its active and systemic use can help to detect ischemia at the reversible stage. The article examines in detail the indications for the application of this diagnostic study. The question of preference for the revascularization method remains debatable. The arguments of proponents of open and endovascular interventions on mesenteric vessels are presented. Other, still unresolved tactical issues are also considered, such as indications for re-operations and application of the principles of damage control tactics.

Keywords:

acute mesenteric ischemia

CT angiography

revascularization

mesenteric vessels

Authors:

Pankratov A.A.

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov;
City Clinical Hospital named after V.P. Demihov of the Moscow City Health Department

Perehodov S.N.

City Clinical Hospital named after V.P. Demihov of the Moscow City Health Department

Zelenin D.A.

City Clinical Hospital named after V.P. Demihov of the Moscow City Health Department

Izrailov R.E.

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

SPIN RSCI: 7121-2776
Scopus AuthorID: 56571607000
ORCID: 0000-0001-7254-5411

Matkov I.V.

City Clinical Hospital named after V.P. Demihov of the Moscow City Health Department

Received:

20.09.2020

Accepted:

10.10.2020

Close metadata

References:

Bala M, Kashuk J, Moore EE, Kluger Y, Biffl W, Gomes CA, Ben-Ishay O, Rubinstein C, Balogh ZJ, Civil I, Coccolini F, Leppaniemi A, Peitzman A, Ansaloni L, Sugrue M, Sartelli M, Di Saverio S, Fraga GP, Catena F. Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery. World Journal of Emergency Surgery. 2017;12(38):1-11. https://doi.org/10.1186/s13017-017-0150-5
Acosta S. Mesenteric ischemia. Curr Opin Crit Care. 2015;21(2): 171-178. https://doi.org/10.1097/MCC.0000000000000189
Clair DG, Beach JM. Mesenteric ischemia. N Engl J Med. 2016;374(10):959-968. https://doi.org/10.1056/NEJMra1503884
Björck M, Koelemay M, Acosta S, Bastos Goncalves F, Kölbel T, Kolkman JJ, Lees T, Lefevre JH, Menyhei G, Oderich G, Kolh P, de Borst GJ, Chakfe N, Debus S, Hinchliffe R, Kakkos S, Koncar I, Sanddal Lindholt J, Vega de Ceniga M, Vermassen F, Verzini F, Geelkerken B, Gloviczki P, Huber T, Naylor R. Editor’s Choice — Management of the Diseases of Mesenteric Arteries and Veins. Clinical Practice Guidelines of the European Society of Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2017;53:460-510. https://doi.org/10.1016/j.ejvs.2017.01.010
Klar E, Rahmanian PB, Bücker A, Hauenstein K, Jauch KW, Luther B. Acute mesenteric ischemia: a vascular emergency. Dtsch Arztebl Int. 2012;109(14):249-256. https://doi.org/10.3238/arztebl.2012.0249
Kärkkäinen JM, Lehtimäki TT, Manninen H, Paajanen H. Acute mesenteric ischemia is a more common cause than expected of acute abdomen in the elderly. J Gastrointest Surg. 2015;19(8):1407-1414. https://doi.org/10.1007/s11605-015-2830-3
Acosta S, Ogren M, Sternby NH, Bergqvist D, Björck M. Clinical implications for the management of acute thromboembolic occlusion of the superior mesenteric artery: autopsy findings in 213 patients. Ann Surg. 2005;241(3):516-522. https://doi.org/10.1097/01.sla.0000154269.52294.57
Klas AA. Embolectomy in acute mesenteric occlusion. Ann Surg. 1951;134(5):913-917. https://doi.org/10.1097/00000658-195111000-00016
Cokkinis AJ. Mesenteric vascular occlusion. London: Bailliere, Tindall and Cox; 1926.
Björck M. Trans-Atlantic Debate: Is an «Endovascular First» Strategy the Optimal Approach for Treating Acute Mesenteric Ischemia? Part One: For the Motion. An Endovascular First Strategy is the Optimal Approach for Treating Acute Mesenteric Ischemia. Eur J Vasc Endovasc Surg. 2015;50:273-275. https://doi.org/10.1016/j.ejvs.2015.04.025
Luther B, Mamopoulos A, Lehmann C, Klar E. The Ongoing Challenge of Acute Mesenteric Ischemia. Visc Med. 2018;34(3):217-223. https://doi.org/10.1159/000490318
Paes E, Vollmar JF, Hutschenreiter S, Schoenberg MH, Schölzel E. Diagnostik und Therapie des akuten Mesenterialinfarktes. Chir Gastroenterol. 1990;6:473-480.
Walter P, Lindemann W, Koch B, Feifel G. Der akute Mesenterialinfarkt. Klinikarzt. 1992;21:457-463.
Park WM, Gloviczki P, Cherry KJ Jr, Hallett JW Jr, Bower TC, Panneton JM, Schleck C, Ilstrup D, Harmsen WS, Noel AA. Contemporary management of acute mesenteric ischemia: factors associated with survival. J Vasc Surg. 2002;35(3):445-452. https://doi.org/10.1067/mva.2002.120373
Acosta S, Björck M. Acute thrombo-embolic occlusion of the superior mesenteric artery: a prospective study in awell defined population. Eur J Vasc Endovasc Surg. 2003;26(2):179-183. https://doi.org/10.1053/ejvs.2002.1893
Björnsson S, Resch T, Acosta S. Symptomatic mesenteric atherosclerotic disease-lessons learned from the diagnostic workup. J Gastrointest Surg. 2013;17(5):973-980. https://doi.org/10.1007/s11605-013-2139-z
Matsumoto S, Sekine K, Funaoka H, Yamazaki M, Shimizu M, Hayashida K, Kitano M. Diagnostic performance of plasma biomarkers in patients with acute intestinal ischaemia. Br J Surg. 2014;101(3):232-238. https://doi.org/10.1002/bjs.9331
Treskes N, Persoon AM, van Zanten ARH. Diagnostic accuracy of novel serological biomarkers to detect acute mesenteric ischemia: a systematic review and meta-analysis. Intern Emerg Med. 2017;12(6):821-836. https://doi.org/10.1007/s11739-017-1668-y
Nuzzo A, Maggiori L, Ronot M, Becq A, Plessier A, Gault N, Joly F, Castier Y, Vilgrain V, Paugam C, Panis Y, Bouhnik Y, Cazals-Hatem D, Corcos O. Predictive factors of intestinal necrosis in acute mesenteric ischemia: prospective study from an intestinal stroke center. Am J Gastroenterol. 2017;112(4):597-605. https://doi.org/10.1038/ajg.2017.38
Akyildiz H, Akcan A, Oztürk A, Sozuer E, Kucuk C, Karahan I. The correlation of the D-dimer test and biphasic computed tomography with mesenteric computed tomography angiography in the diagnosis of acute mesenteric ischemia. American journal of surgery. 197(4):429-433. https://doi.org/10.1016/j.amjsurg.2008.02.011
Barmase M, Kang M, Wig J, Kochhar R, Gupta R, Khandelwal N. Role of multidetector CT angiography in the evaluation of suspected mesenteric ischemia. Eur J Radiol. 2011;80(3):e582-587. https://doi.org/10.1016/j.ejrad.2011.09.015
Aschoff AJ, Stuber G, Becker BW, Hoffmann MH, Schmitz BL, Schelzig H, Jaeckle T. Evaluation of acute mesenteric ischemia: accuracy of biphasic mesenteric multi-detector CT angiography. Abdom Imaging. 2009;34(3):345-357. https://doi.org/10.1007/s00261-008-9392-8
Ofer A, Abadi S, Nitecki S, Karram T, Kogan I, Leiderman M, Shmulevsky P, Israelit S, Engel A. Multidetector CT angiography in the evaluation of acute mesenteric ischemia. Emerg Radiol. 2009;20:139-147. https://doi.org/10.1007/s00330-008-1124-5
Yikilmaz A, Karahan OI, Senol S, Tuna IS, Akyildiz HY. Value of multislice computed tomography in the diagnosis of acute mesenteric ischemia. Eur J Radiol. 2011;80(2):297-302. https://doi.org/10.1016/j.ejrad.2010.07.016
Bani Hani M, Kamangar F, Goldberg S, Greenspon J, Shah P, Volpe C, Turner DJ, Horton K, Fishman EK, Francis IR, Daly B, Cunningham SC. Pneumatosis and portal venous gas: do CT findings reassure? J Surg Res. 2013;185(2):581-586. https://doi.org/10.1016/j.jss.2013.06.006
Arthurs ZM, Titus J, Bannazadeh M, Eagleton MJ, Srivastava S, Sarac TP, Clair DG. A comparison of endovascular revascularization with traditional therapy for the treatment of acute mesenteric ischemia. J Vasc Surg. 2011;53(3):698-704. https://doi.org/10.1016/j.jvs.2010.09.049
Beaulieu RJ, Arnaoutakis KD, Abularrage CJ, Efron DT, Schneider E, Black JH 3rd. Comparison of open and endovascular treatment of acute mesenteric ischemia. J Vasc Surg. 2014;59(1):159-164. https://doi.org/10.1016/j.jvs.2013.06.084
Branco BC, Montero-Baker MF, Aziz H, Taylor Z, Mills JL.Endovascular Therapy for Acute Mesenteric Ischemia: an NSQIP Analysis. Am Surg. 2015;81(11):1170-1176.
Orr NT, Endean ED. Trans-Atlantic Debate: Is an “Endovascular First” Strategy the Optimal Approach for Treating Acute Mesenteric Ischemia? Part Two: Against the Motion. An Endovascular First Strategy is not the Optimal Approach for Treating Acute Mesenteric Ischemia. Eur J Vasc Endovasc Surg. 2015;50(3):276-279. https://doi.org/10.1016/j.ejvs.2015.04.026
Oderich GS, Tallarita T, Gloviczki P, Duncan AA, Kalra M, Misra S, Cha S, Bower TC. Mesenteric artery complications during angioplasty and stent placement for atherosclerotic chronic mesenteric ischemia. J Vasc Surg. 2012;55(4):1063-1071. https://doi.org/10.1016/j.jvs.2011.10.122
Unalp HR, Atahan K, Kamer E, Yaşa H, Tarcan E, Onal MA. Prognostic factors for hospital mortality in patients with acute mesenteric ischemia who undergo intestinal resection due to necrosis. Ulus Travma Acil Cerrahi Derg. 2010;16(1):63-70.
Subramanian A, Balentine C, Palacio CH, Sansgiry S, Berger DH, Awad SS. Outcomes of damage-control celiotomy in elderly non trauma patients with intra-abdominal catastrophes. Am J Surg. 2010;200(6):783-788. https://doi.org/10.1016/j.amjsurg.2010.07.027
Weber DG, Bendinelli C, Balogh ZJ. Damage control surgery for abdominal emergencies. Br J Surg. 2014;101(1):e109-118. https://doi.org/10.1002/bjs.9360