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Cited by 64Abdominal vascular conditions and treatmentsIntestinal and Peritoneal AdhesionsAppendicitis Diagnosis and Management

Management of Acute Mesenteric Ischemia: A Critical Review and Treatment Algorithm

Zhao, Yang, Yin, Henghui, Yao, Chen, Deng, Jiong, Wang, Mian, Li, Zilun, Chang, Guangqi·2016·Vascular and Endovascular Surgery
DOI 10.1177/1538574416639151
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Abstract

Background: Acute mesenteric ischemia (AMI) due to a sudden loss or decrease in blood perfusion to the mesentery represents a highly lethal condition. However, the optimal surgical management remains debatable and merits a more clear recommendation based on a higher level of evidence. Methods: A systematic review of articles published between 2000 and 2013 was performed. Patients were divided into endovascular treatment (ET), open surgery (OS), and hybrid technique (HT) groups. Data of patients’ demographics, procedural information, clinical outcomes including mortality, morbidity, primary patency rate, technique success, primary intestinal resection rate, and second-look laparotomy rate, and follow-up were all retrieved. Comparison between the ET and the OS groups was made using 2-sided Student t test and 2-sided χ 2 test or Fisher exact test where appropriate. Results: Twenty-eight articles with a total of 1110 patients were included for the review. The ET group had lower in-hospital mortality and morbidity but similar survival rate during follow-up compared to the OS group. The primary patency rate was higher in the ET group. The overall bowel resection rate was lower in the ET group, and nearly every patient in the cohort who required second-look laparotomy required bowel resection. The HT group seemed to have the lowest mortality and acceptable second-look laparotomy rate and morbidity. Comparison between the HT group and other groups was not possible due to the limited number of cases available for review. Conclusion: Endovascular treatment may serve as a first-line therapy for select patients when there is a low suspicion for intestinal necrosis. Open surgery should be reserved for emergency conditions requiring exploratory laparotomy. Hybrid technique may be an especially effective approach for treating AMI, with low morbidity and mortality, although further studies are required comparing it to OS and ET.

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Crossref · 10.1177/1538574416639151

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  • Heterogeneous clinical manifestations and pathophysiological mechanisms of different subtypes of AMI usually result in multiple specialties being involved in the primary diagnosis and management of AMI.

    “Heterogeneous clinical manifestations and pathophysiological mechanisms of different subtypes of AMI (occlusive arterial or venous, non-occlusive) usually result in multiple specialties being involved in the primary diagnosis and management of AMI [3–7], and key similarities and differences between subtypes of AMI are incompletely studied.”

    From Incidence, diagnosis, management and outcome of acute mesenteric ischaemia: a prospective, multicentre observational study (AMESI Study) (2024) · cites this paper as [5]

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Authors
Zhao, Y., Yin, H., Yao, C., Deng, J., Wang, M., Li, Z., & Chang, G.
Affiliations
Sun Yat-sen University (CN)
Corresponding author
  • Li, Zilun
  • Chang, Guangqi
ORCID
Venue
Vascular and Endovascular Surgery
Publisher
SAGE Publications
Published
2016-04
Volume
50
Issue
3
Pages
183-192
ISSN
  • 1538-5744 (ISSN-L)
  • 1938-9116
DOI
10.1177/1538574416639151
OpenAlex
W2317209377
Cited by
64
References
47
Citations by year
2026: 2 · 2025: 6 · 2024: 5 · 2023: 8 · 2022: 6 · 2021: 9 · 2020: 3 · 2019: 7 · 2018: 7 · 2017: 9 · 2016: 2
FWCI
9.22
Type
journal article
Language
en
Open access
closed
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Vascular and Endovascular Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
  • Health Sciences › Medicine › Surgery › Intestinal and Peritoneal Adhesions
  • Health Sciences › Medicine › Emergency Medicine › Appendicitis Diagnosis and Management
Keywords
acute mesenteric ischemia, endovascular treatment, open surgery, hybrid technique, mesenteric artery occlusion, in-hospital mortality, postoperative morbidity, primary patency, bowel resection, second-look laparotomy, intestinal necrosis
MeSH terms
Acute Disease, Algorithms, Humans, Mesenteric Vascular Occlusion, Risk Factors, Splanchnic Circulation, Vascular Surgical Procedures, Chi-Square Distribution, Odds Ratio, Treatment Outcome, Critical Pathways, Kaplan-Meier Estimate, Endovascular Procedures, Mesenteric Ischemia

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