Endovascular Management of Intestinal Ischemia

Abstract

Abstract Background Mesenteric ischemia requiring revascularization is associated with high mortality in both chronic and acute forms. Disparate etiologies and nonspecific symptoms make the diagnosis challenging and often result in delayed diagnosis and intervention. More often surgery is required and is frequently lifesaving. Percutaneous transcatheter techniques are increasingly employed in both diagnosis and treatment. Aim and Objectives To highlight the recent trends in management of patients with mesenteric vascular occlusion. Subjects and Methods This was is a prospective study, conducted at Ain Shams University Hospitals and Nasser institute Hospital in Cairo on 30 patients complaining of acute or chronic intestinal ischemia in the form of abdominal pain and post prandial meal. Result Among the studied cases there were 4 (13.3%) with complete effect of thrombolysis, 1 (3.3%) with partial effect, 2 (6.7%) with no lysis, 8 (25.7%) with dilatation, 13 (43.3%) dilatation and stent and 13 (43.3%) with failed dilatation. Conclusion Endovascular intervention can be an alternative to open surgery for intestinal revascularization for the management of early cases of acute SMA occlusion. CTA rapid diagnosis, urgent endovascular management and intensive care and follow up are the cornerstone for good prognosis.