Local Intra-arterial Vasodilator Infusion in Non-Occlusive Mesenteric Ischemia Significantly Increases Survival Rate
Open accessAbstract
Purpose: To investigate the outcome of local intra-arterial papaverine infusion therapy in patients with non-occlusive mesenteric ischemia (NOMI), and factors influencing survival, in comparison with a conservative approach. Methods: From 2013 to 2019 , patients with NOMI confirmed by imaging were included in a retrospective two-center study. According to different in-house standard procedures, patients were treated in each center either conservatively or interventionally by a standardized local infusion of intra-arterial papaverine into the splanchnic arteries. Thirty-day mortality and factors influencing the outcome, such as different demographics and laboratories, were compared between groups using Kaplan–Meier survival analysis and Cox regression, respectively. Results: A total of 66 patients with NOMI were included, with n = 35 treated interventionally (21 males, mean age 67.7 ± 12.3 years) and n = 31 treated conservatively (18 females, mean age 71.6 ± 9.6 years). There was a significant difference in 30-day mortality between the interventional (65.7%; 12/35 survived) and the conservative group (96.8%; 1/31 survived) (hazard ratio 2.44; P = 0.005). Thresholds associated with a worse outcome of interventional therapy are > 7.68 mmol/l for lactate, < 7.31 for pH and < − 4.55 for base excess. Conclusion: Local intra-arterial papaverine infusion therapy in patients with NOMI significantly increases survival rate in comparison with conservative treatment. High lactate levels, low pH and high base excess, and high demand for catecholamines are associated with a poor outcome. Level of Evidence: Level III.
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This finding was corroborated in another non-randomised retrospective comparative study of 66 patients with NOMI where intra-arterial papaverine was associated with a lower mortality rate (23/35; 66%) than standard treatment (30/31; 97%).
“This finding was corroborated in another non-randomised retrospective comparative study of 66 patients with NOMI where intra-arterial papaverine was associated with a lower mortality rate (23/35; 66%) than standard treatment (30/31; 97%). 200”
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Cites
Measures of Diagnostic Accuracy: Basic Definitions.
Šimundić, A.-M. (2009) · PubMed Central · Cited by 1,266 · see citing works
Measures of diagnostic accuracy: basic definitions
Šimundić, A.-M. (2009) · Medical and Biological Sciences · Cited by 1,144 · see citing works
ESTES guidelines: acute mesenteric ischaemia
Tilsed, J. V. T., Casamassima, A., Kurihara, H., Mariani, D., Martinez, I., Pereira, J., Ponchietti, L., Shamiyeh, A., al-Ayoubi, F., Barco, L. A. B., et al. (2016) · European Journal of Trauma and Emergency Surgery · doi:10.1007/s00068-016-0634-0 · Cited by 382 · see citing works
Non-occlusive mesenteric ischemia: etiology, diagnosis, and interventional therapy
Trompeter, M., Brazda, T., Remy, C. T., Vestring, T., & Reimer, P. (2002) · European Radiology · doi:10.1007/s00330-001-1220-2 · Cited by 378 · see citing works
Epidemiology of Mesenteric Vascular Disease: Clinical Implications
Acosta, S. (2010) · Seminars in Vascular Surgery · doi:10.1053/j.semvascsurg.2009.12.001 · Cited by 340 · see citing works
(1977) · PubMed · Cited by 278 · see citing works
Adjusting Survival Curves for Confounders: A Review and a New Method
Nieto, F. J., & Coresh, J. (1996) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a008670 · Cited by 221 · see citing works
Mitsuyoshi, A., Obama, K., Shinkura, N., Ito, T., & Zaima, M. (2007) · Annals of Surgery · doi:10.1097/01.sla.0000263157.59422.76 · Cited by 202 · see citing works
Ischemic Diseases of the Bowel
Reinus, J. F., Brandt, L. J., & Boley, S. J. (1990) · Gastroenterology Clinics of North America · doi:10.1016/s0889-8553(21)00499-4 · Cited by 168 · see citing works
Acute mesenteric ischemia: angiographic spectrum
Clark, R., & Gallant, T. (1984) · American Journal of Roentgenology · doi:10.2214/ajr.142.3.555 · Cited by 155 · see citing works
Diagnosis and treatment of nonocclusive mesenteric ischemia after open heart surgery
Klotz, S., Vestring, T., Rötker, J., Schmidt, C., Scheld, H. H., & Schmid, C. (2001) · The Annals of Thoracic Surgery · doi:10.1016/s0003-4975(01)03179-4 · Cited by 154 · see citing works
Sise, M. J. (2013) · Surgical Clinics of North America · doi:10.1016/j.suc.2013.10.012 · Cited by 118 · see citing works
Al-Diery, H., Phillips, A., Evennett, N., Pandanaboyana, S., Gilham, M., & Windsor, J. A. (2019) · Journal of Intensive Care Medicine · doi:10.1177/0885066618788827 · Cited by 117 · see citing works
Woodhams, R., Nishimaki, H., Fujii, K., Kakita, S., & Hayakawa, K. (2009) · European Journal of Radiology · doi:10.1016/j.ejrad.2009.05.012 · Cited by 103 · see citing works
Pérez-García, C., de Miguel Campos, E., Fernández Gonzalo, A., Malfaz, C., Martín Pinacho, J. J., Fernández Álvarez, C., & Herranz Pérez, R. (2018) · The British Journal of Radiology · doi:10.1259/bjr.20170492 · Cited by 81 · see citing works
(1993) · PubMed · Cited by 65 · see citing works
Wilms, H. R., Mittal, A., Haydock, M. D., van den Heever, M., Devaud, M., & Windsor, J. A. (2013) · Journal of Critical Care · doi:10.1016/j.jcrc.2013.10.019 · Cited by 61 · see citing works
Stahl, K., Busch, M., Maschke, S. K., Schneider, A. S., Manns, M. P., Fuge, J., Wiesner, O., Meyer, B., Hoeper, M. M., Hinrichs, J. B., et al. (2019) · Journal of Intensive Care Medicine · doi:10.1177/0885066619837911 · Cited by 50 · see citing works
Ambe, P. C., Kang, K., Papadakis, M., & Zirngibl, H. (2017) · BioMed Research International · doi:10.1155/2017/8038796 · Cited by 44 · see citing works
Acute Mesenteric Ischemia after Cardiac Surgery: An Analysis of 52 Patients
Eriş, C., Yavuz, Ş., Yalçınkaya, S., Gücü, A., Toktaş, F., Yümün, G., Erdolu, B., & Ozyazicioglu, A. F. (2013) · The Scientific World JOURNAL · doi:10.1155/2013/631534 · Cited by 42 · see citing works
[Diagnosis and therapy of non-occlusive mesenteric ischemia (NOMI)].
Stöckmann, H., Roblick, U. J., Kluge, N., Kunze, U., Schimmelpenning, H., Kujath, P., Müller, G. H., & Bruch, H. ‐. (2000) · PubMed · Cited by 40 · see citing works
Vasopressin as Therapy During Nonocclusive Mesenteric Ischemia
Bomberg, H., Groesdonk, H. V., Raffel, M., Minko, P., Schmied, W., Klingele, M., & Schäfers, H. (2016) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2016.03.025 · Cited by 37 · see citing works
Vasodilatory Drugs in the Management of Nonocclusive Bowel Ischemia
Athanasoulis, C. A., WITTENBERG, J., Bernstein, R., & Williams, L. F. (1975) · Gastroenterology · doi:10.1016/s0016-5085(75)80060-6 · Cited by 36 · see citing works
Angiography in Acute Superior Mesenteric Arterial Insufficiency
Aakhus, T., & Brabrand, G. (1967) · Acta Radiologica Diagnosis · doi:10.1177/028418516700600101 · Cited by 36 · see citing works
Aktuelle Diagnostik und Therapie der nicht okklusiven mesenterialen Ischämie
Ernst, S., Luther, B., Zimmermann, N., Böhner, H., Wilke, R., Feindt, P. R., & Fürst, G. (2003) · RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren · doi:10.1055/s-2003-38441 · Cited by 35 · see citing works
Huwer, H., Winning, J., Straub, U., Isringhaus, H., & Kalweit, G. A. (2004) · Vascular · doi:10.1258/rsmvasc.12.2.114 · Cited by 30 · see citing works
Mesenteric ischemia after a cardiac operation: Conservative treatment with local vasodilation
Niederhäuser, U., Genoni, M., von Segesser, . K., Brühlmann, W. F., & Turina, M. I. (1996) · The Annals of Thoracic Surgery · doi:10.1016/0003-4975(95)01198-6 · Cited by 27 · see citing works
Defining Goals of Resuscitation in the Critically Ill Patient
Joosten, A., Alexander, B. S., & Cannesson, M. P. (2014) · Critical Care Clinics · doi:10.1016/j.ccc.2014.08.006 · Cited by 21 · see citing works
Huwer, H., Winning, J., Straub, U., et al. (2004) · Vascular · doi:10.2310/6670.2004.20769 · Cited by 21 · see citing works
Eker, A., Malzac, B., Teboul, J., & Jourdan, J. (1999) · European Journal of Cardio-Thoracic Surgery · doi:10.1016/s1010-7940(98)00260-7 · Cited by 19 · see citing works
Iloprost, Prostaglandin E1, and Papaverine Relax Human Mesenteric Arteries With Similar Potency
Mahlke, C., Kühn, J., Mensel, B., Schreiber, A., Juretzko, A., Steinbach, A. C., & Grisk, O. (2017) · Shock · doi:10.1097/shk.0000000000000866 · Cited by 12 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Koelemay, M. J., Geelkerken, R. H., Kärkkäinen, J., Leone, N., Antoniou, G. A., de Bruin, J. L., Gombert, A., Gottsätter, A., Iborra, E., Ronchey, S., et al. (2025) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2025.06.010 · Cited by 123 · see citing works
ACR Appropriateness Criteria® radiologic management of mesenteric ischemia: 2022 update
Lam, A., Kim, Y.-J., Fidelman, N., Higgins, M., Cash, B. D., Charalel, R. A., Guimaraes, M. S., Kwan, S. W., Patel, P. J., Plett, S., et al. (2022) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2022.09.006 · Cited by 29 · see citing works
Rittgerodt, N., Pape, T., Busch, M., Becker, L. S., Schneider, A., Wedemeyer, H., Seeliger, B., Schmidt, J., Hunkemöller, A. M., Fuge, J., et al. (2022) · Critical Care · doi:10.1186/s13054-022-03962-w · Cited by 26 · see citing works
Diagnosis and management of acute mesenteric ischemia: What you need to know
Tolonen, M., & Vikatmaa, P. (2025) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0000000000004585 · Cited by 13 · see citing works
Management of acute mesenteric ischaemia in adult patients: a systematic review and meta-analysis
Blaser, A. R., Koitmäe, M., Bachmann, K. F., Gaetano, P. D., Kiisk, E., Laisaar, K.-T., Piva, S., Stahl, K., Tamme, K., & Acosta, S. (2025) · World Journal of Emergency Surgery · doi:10.1186/s13017-025-00614-6 · Cited by 11 · see citing works
The Evaluation and Management of Intestinal Ischemia
Theodore, S., Xia, T., & Saillant, N. N. (2024) · NEJM Evidence · doi:10.1056/evidra2400057 · Cited by 8 · see citing works
Non-Occlusive Mesenteric Ischemia in Cardiac Arrest Patients
Šmalcová, J., & Bělohlávek, J. (2023) · Reviews in Cardiovascular Medicine · doi:10.31083/j.rcm2409262 · Cited by 6 · see citing works
Murata, T., Kawachi, J., Igarashi, Y., Suno, Y., Nishida, T., Miyake, K., Isogai, N., Fukai, R., Kashiwagi, H., Shimoyama, R., et al. (2021) · Medicine · doi:10.1097/md.0000000000028056 · Cited by 6 · see citing works
Calame, P., Nuzzo, A., & Ronot, M. (2020) · CardioVascular and Interventional Radiology · doi:10.1007/s00270-020-02696-y · Cited by 6 · see citing works
Murata, T., Yamaguchi, N., Shimomoto, Y., Mikajiri, Y., Sasaki, Y., Konagaya, K., Igarashi, Y., Sawamura, N., Yamamoto, K., Kume, N., et al. (2023) · International Journal of Surgery · doi:10.1097/js9.0000000000000733 · Cited by 5 · see citing works
Ohira, G., Hayano, K., Tochigi, T., Maruyama, T., Toyozumi, T., Kurata, Y., Maruyama, M., Arai, S., Nakada, T., & Matsubara, H. (2024) · Surgery Today · doi:10.1007/s00595-024-02909-8 · Cited by 5 · see citing works
Winzer, R., Martin, R., Baldus, J. C., Heidrich, F. M., Hoberück, S., Hoffmann, R., & Fedders, D. (2020) · European Journal of Radiology · doi:10.1016/j.ejrad.2020.109370 · Cited by 4 · see citing works
Self-citationNOMI after cardiac arrest. Could refined diagnostics improve outcome?
Schött, U., & Kander, T. (2020) · Resuscitation · doi:10.1016/j.resuscitation.2020.10.012 · Cited by 4 · see citing works
Tricky acute mesenteric ischemia: what can we do?
Cui, X.-Y., Chen, Y., Guan, G., Luo, F., & Zhang, Z. (2025) · Gastroenterology Report · doi:10.1093/gastro/goaf067 · Cited by 2 · see citing works
Atherosclerosis is a risk factor of mortality in patients with non-occlusive mesenteric ischemia
Kawada, T. (2021) · European Journal of Radiology · doi:10.1016/j.ejrad.2021.109720 · Cited by 2 · see citing works
Okumura, E., Jimbo, H., Sunaga, S., Otsuka, K., Okada, H., & ONITSUKA, T. (2021) · NMC Case Report Journal · doi:10.2176/nmccrj.cr.2021-0001 · Cited by 2 · see citing works
Nonocclusive Mesenteric Ischemia: A Review for Interventional Radiologists
Kawada, H., Nagata, S., Noda, Y., Kawai, N., Ando, T., Kaga, T., Suto, T., Kondo, H., & Matsuo, M. (2024) · Interventional Radiology · doi:10.22575/interventionalradiology.2023-0026 · Cited by 3 · see citing works
Stahl, K., Bode, C., & David, S. (2024) · Intensive Care Medicine · doi:10.1007/s00134-024-07403-w · Cited by 2 · see citing works
Kawamoto, M., Miyasaka, Y., Koreeda, N., Hirano, Y., Yamamoto, R., & Watanabe, M. (2024) · Clinical Journal of Gastroenterology · doi:10.1007/s12328-024-01954-7 · Cited by 1 · see citing works
Association of Perioperative Vasodilator Therapy and Mortality in Nonocclusive Mesenteric Ischemia
Takami, T., Mizuno, K., Obama, K., & Kawakami, K. (2025) · Journal of Surgical Research · doi:10.1016/j.jss.2025.08.017 · Cited by 1 · see citing works
Mesenteriale Ischämie in der Intensivmedizin
Junginger, A., & Braun, G. (2021) · Intensivmedizin up2date · doi:10.1055/a-1171-5020 · Cited by 1 · see citing works
Acute Mesenteric Ischaemia: Imaging and Intervention
Howroyd, L. R., Hawthorn, B. R., Patel, N., & Ratnam, L. (2024) · Springer eBooks · doi:10.1007/978-3-031-56270-9_26 · Cited by 1 · see citing works
綾華, 松., 聡, 井., 三池徹, 良太, 櫻., 秀哲, 江., Iwamoto, S., & 雄一郎, 阪. (2021) · Nihon Kyukyu Igakukai Zasshi Journal of Japanese Association for Acute Medicine · doi:10.1002/jja2.12616
Intraarterielle Papaverin-Infusion bei nicht okklusiver mesenterialer Ischämie
(2020) · Gefäßmedizin Scan - Zeitschrift für Angiologie Gefäßchirurgie diagnostische und interventionelle Radiologie · doi:10.1055/a-1224-7856
Nonocclusive mesenteric ischemia caused by type B aortic dissection: a case report
Sheng, M., Gong, W., Zhao, K., Li, W., Qian, A., Chang, L., Wu, Y., Chen, Q., Chen, Z., Yang, X., et al. (2022) · BMC Surgery · doi:10.1186/s12893-022-01656-2
Campion, E. M., Hoehn, M. R., & Burlew, C. C. (2022) · Springer eBooks · doi:10.1007/978-3-031-07881-1_18
Acute Mesenteric Ischemia: Evaluation, Management, and Interventions
Kaufman, C. S. (2022) · Digestive Disease Interventions · doi:10.1055/s-0042-1757764
Intestinal protection and management in cardiopulmonary bypass
Harky, A., Wright, K., & Melamed, N. (2023) · Elsevier eBooks · doi:10.1016/b978-0-443-18918-0.00048-6
Nichtokklusive mesenteriale Ischämie
Schaab, F. (2023) · coloproctology · doi:10.1007/s00053-023-00692-7
Renal and visceral vessels lesions: how to manage them
Vani, K. T., Calligaro, K. D., Maloni, K. C., Dowdy, C. E., Troutman, D. A., & Dougherty, M. J. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-822113-6.00015-2
A Case of Nonocclusive Mesenteric Ischemia During Bioradiotherapy With Cetuximab
Kuribayashi, N., Tokuzen, N., Goda, H., Hino, S., & Uchida, D. (2024) · Cureus · doi:10.7759/cureus.57229
Grewal, S., Kansagra, K., Stone, J. R., & Vatakencherry, G. (2024) · Springer eBooks · doi:10.1007/978-3-031-52546-9_27
Computed Tomography Imaging of Acute Mesenteric Ischemia for Interventional Radiology
Inoue, A., Chatani, S., Uemura, R., Imai, Y., Tomozawa, Y., Murakami, Y., Sonoda, A., Roberts, N., & Watanabe, Y. (2024) · Interventional Radiology · doi:10.22575/interventionalradiology.2024-0013 · Cited by 1 · see citing works
Impact of Vasospasm on the Effects of N-butyl Cyanoacrylate Embolization in Swine Arteries
Miyake, Y., Yonemitsu, T., Shima, N., Fukuda, K., Fukui, T., Shibata, N., Ikoma, A., Inoue, S., & Sonomura, T. (2025) · Interventional Radiology · doi:10.22575/interventionalradiology.2024-0068
Rittgerodt, N., Pape, T., Busch, M., Becker, L. S., Schneider, A. S., Wedemeyer, H., Seeliger, B., Schmidt, J. J., Hunkemöller, A. M., Fuge, J., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19518338
Rittgerodt, N., Pape, T., Busch, M., Becker, L. S., Schneider, A. S., Wedemeyer, H., Seeliger, B., Schmidt, J. J., Hunkemöller, A. M., Fuge, J., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19518335
Rittgerodt, N., Pape, T., Busch, M., Becker, L. S., Schneider, A. S., Wedemeyer, H., Seeliger, B., Schmidt, J. J., Hunkemöller, A. M., Fuge, J., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19518344
Rittgerodt, N., Pape, T., Busch, M., Becker, L. S., Schneider, A. S., Wedemeyer, H., Seeliger, B., Schmidt, J. J., Hunkemöller, A. M., Fuge, J., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19518341
Acute mesenteric ischemia in cirrhosis: Diagnostic and management challenges
Hassan, A. S., Laor, B., & Benmassaoud, A. (2026) · World Journal of Hepatology · doi:10.4254/wjh.v18.i4.114916
Kourgiali, C. G., Gotti, K.-K. E., Velikoudi, M. D., & Chatzelas, D. A. (2026) · Cureus · doi:10.7759/cureus.114102
Pape, T., Wendel‐Garcia, P. D., Rittgerodt, N., Nalbant, B., Hinrichs, J., Becker, L. S., Hunkemöller, A. M., Raith, J., Boblitz, S. K. J., Ruwisch, J., et al. (2026) · Intensive Care Medicine Experimental · doi:10.1186/s40635-026-00963-9
Management of nonocclusive mesenteric ischemia: Current progress and future direction
Sun, Y., Liu, C., Pan, H., Wang, H., Sun, Y., He, S., & Hu, H. (2026) · Vascular Investigation and Therapy · doi:10.4103/vit.vit-d-26-00014
- Authors
- Winzer, R., Fedders, D., Backes, M., Ittermann, T., Gründling, M., Mensel, B., Held, H.-C., Kromrey, M.-L., Weitz, J., Hoffmann, R.-T., Bülow, R., & Kühn, J.-P.
- Affiliations
- University Hospital Carl Gustav Carus (DE)
- Universitätsmedizin Greifswald (DE)
- Zentralklinik Bad Berka (DE)
- Corresponding author
- Winzer, Robert
- ORCID
- Venue
- CardioVascular and Interventional Radiology
- Published
- 2020-05-22
- Volume
- 43
- Issue
- 8
- Pages
- 1148-1155
- ISSN
- 0174-1551 (ISSN-L)
- 1432-086X
- PMC
- PMC8275548
- OpenAlex
- W3028089728
- Cited by
- 41
- References
- 30
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 9 · 2023: 4 · 2022: 9 · 2021: 6 · 2020: 4
- FWCI
- 5.25
- Type
- journal article
- Language
- en
- Update notices
- correction (2021-07-12)
- Open access
- hybrid
- doi.org
- Locations
- CardioVascular and Interventional Radiology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Informationszentrum Lebenswissenschaften (ZB MED) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Health Sciences › Medicine › Surgery › Abdominal Trauma and Injuries
- Keywords
- nonocclusive mesenteric ischemia, splanchnic arteries, 30-day mortality, conservative treatment, lactate, acid-base status, base excess, catecholamine requirement, survival predictors
- MeSH terms
- Aged, Female, Humans, Infusions, Intra-Arterial, Male, Papaverine, Retrospective Studies, Vasodilator Agents, Survival Rate, Treatment Outcome, Kaplan-Meier Estimate, Mesenteric Ischemia
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