Endovascular treatment and selection criteria for acute mesenteric ischemia

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OBJECTIVE

To demonstrate the results of endovascular intervention in patients with acute arterial mesenteric ischemia, while observing the indications developed in the clinic.

MATERIAL AND METHODS

In total, endovascular approach in the treatment of acute mesenteric ischemia were used in 49 patients in the clinic. In compliance with the developed indications and criteria, endovascular intestinal revascularization was performed in 27 patients. Various endovascular intervention techniques were used (aspiration, balloon dilation, artery stenting and their combinations). Extracorporeal filtration techniques were used as a treatment for reperfusion syndrome after intestinal revascularization in 10 patients.

RESULTS

Angiographic success in the form of complete restoration of the main blood flow in the basin of the superior mesenteric artery and its large branches was obtained in 85% of cases. Intestinal viability was preserved in 15 (56%) patients. After successful endovascular surgery, intestinal necrosis was diagnosed on laparoscopy in the remaining 12 (44%) patients, which required extensive (n=2) or non-extensive (n=10) resection. Postoperative mortality was 48% (13 patients).

CONCLUSION

Endovascular surgery in acute mesenteric ischemia is an effective method of intestinal revascularization. To optimize the indications for these interventions, it is necessary to gain experience and conduct large-scale studies.

Keywords:

acute mesenteric ischemia

endovascular treatment

intestinal ischemia/reperfusion injury

mortality

Authors:

Mironkov A.B.

Pirogov Russian National Research Medical University;
Buyanov City Clinical Hospital

ORCID: 0000-0003-0951-908X

Pryamikov A.D.

Pirogov Russian National Research Medical University;
Buyanov City Clinical Hospital

ORCID: 0000-0002-4202-7549

Rautbart S.A.

Buyanov City Clinical Hospital

ORCID: 0000-0001-8833-3886

Khripun A.I.

Pirogov Russian National Research Medical University

ORCID: 0000-0001-7669-0835

Received:

20.04.2024

Accepted:

15.05.2025

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