Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct 6;13(10):e18544.
doi: 10.7759/cureus.18544. eCollection 2021 Oct.

A Shifting Trend Towards Endovascular Intervention in the Treatment of Acute Mesenteric Ischemia

Ali A Naazar  1 , Ahmad Omair  2 , Samuel H Chu  1 , Kevin G Keane  1 , Dieter G Weber  1
Affiliations

A Shifting Trend Towards Endovascular Intervention in the Treatment of Acute Mesenteric Ischemia

Ali A Naazar et al. Cureus. .

Abstract

Background Acute mesenteric ischemia (AMI) is a vascular emergency with a quite low incidence, but it is associated with disproportionately more severe morbidity and mortality. The aim of this study was to assess the current trend in the treatment of AMI and to see if endovascular intervention is an effective treatment modality in the selected group of patients. Methods A retrospective review of patients admitted with AMI between 2007 and 2018 was performed. Outcome measures were length of stay (LOS) at hospital and intensive care unit (ICU), and post-treatment mortality. Results A total of 98 patients with AMI were admitted during the study period. Patients undergoing endovascular treatment compared with surgery were younger (62.9 ± 13.7 years vs. 69.5 ± 12.8 years; p = 0.01). Shorter LOS in hospital and ICU was observed for those treated with endovascular approach (6.8 ± 3.4 and 3.25 ± 0.5 days) compared to the surgical group (25 ± 8.6 and 12.8 ± 26.8 days; p < 0.001). Out of 39 patients requiring ICU admission, 48.7% were surgically treated and 10.2% underwent endovascular intervention (p < 0.001). Mortality associated with surgery was 30.6% compared to only 6.6% with endovascular intervention (p < 0.001). Between 2007 and 2012, only one patient underwent endovascular intervention and 20 underwent surgery compared to 14 patients treated with endovascular approach and 16 with surgery between 2013 and 2018. Conclusion In this non-randomized, retrospective case series, patients with endovascular treatment fared clinically better and the intervention was found to be safe and feasible in the selected group of patients. We suggest a preference for this modality where possible. At our hospital, a trend favoring this approach is apparent during the last six years.

Keywords: acute mesenteric ischemia; endovascular intervention; mortality; surgery; treatment outcome.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. A bar diagram showing trends of endovascular, surgical, and vascular plus surgical intervention between 2007 and 2018
See this image and copyright information in PMC

References

    1. Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery. Bala M, Kashuk J, Moore EE, et al. World J Emerg Surg. 2017;12:38. - PMC - PubMed
    1. The importance of open emergency surgery in the treatment of acute mesenteric ischemia. Duran M, Pohl E, Grabitz K, Schelzig H, Sagban TA, Simon F. World J Emerg Surg. 2015;10:45. - PMC - PubMed
    1. Management of acute mesenteric ischemia: a critical review and treatment algorithm. Zhao Y, Yin H, Yao C, Deng J, Wang M, Li Z, Chang G. Vasc Endovascular Surg. 2016;50:183–192. - PubMed
    1. Comparison of open and endovascular treatment of acute mesenteric ischemia. Beaulieu RJ, Arnaoutakis KD, Abularrage CJ, Efron DT, Schneider E, Black JH 3rd. J Vasc Surg. 2014;59:159–164. - PubMed
    1. Update in management of mesenteric ischemia. Chang RW, Chang JB, Longo WE. World J Gastroenterol. 2006;12:3243–3247. - PMC - PubMed