Local thrombolytic therapy in acute mesenteric ischemia
Open accessAbstract
BACKGROUND: The aim of the study was to evaluate the local thrombolytic therapy (LTT) in combination with laparoscopy, in management of acute mesenteric ischemia (AMI). METHODS: From January 2000 to January 2010, patients who were admitted to the hospital with AMI due to acute arterial occlusion were analysed retrospectively. Patients presenting with acute abdomen with a suspicion of AMI were evaluated with computerized tomography angiography (CTA). Patients who had findigs of AMI on CTA, were underwent selective mesenteric angiography and LTT eventhough without peritoneal signs. LTT was carried out before or after laparoscopy or laparotomy, and initiated with recombinant plasminogen activator. RESULTS: LTT was performed in 13 (17.1%), out of 76 patients. From the remaining patients, 56 underwent necrotic bowel resection and 7 underwent tromboembolectomy. The median age was 62 years (45-87). The median duration of symptoms was 24 h. Four (30.7%) patients presented within 24 h onset of symptoms, whilst 9 (69.3%) patients presented after 24 h onset of symptoms. There were 5 (39.5%) patients, who presented with abdominal pain without peritoneal signs on physical examination and 8 (61.5%) patients, who had peritoneal signs. The mortality rate was 20% (1/5) in the first group who presented without peritoneal signs, whilst it was 62.5% (5/8) in the remaining. CONCLUSION: Early intervention in AMI is the key to better results. CTA combined with early laparoscopy and LTT may have beneficial effects at this setting.
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Embolectomy of the SMA is possible by both endovascular and open surgical means, but endovascular therapy has the added possibility of intra-arterial thrombolysis if the patient does not have peritonitis or is in immediate need of laparotomy.
“Embolectomy of the SMA is possible by both endovascular and open surgical means, but endovascular therapy has the added possibility of intra-arterial thrombolysis if the patient does not have peritonitis or is in immediate need of laparotomy23.”
From Acute mesenteric ischaemia (2023) · cites this paper as [23]
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- Authors
- Yanar, F., Agcaoglu, O., Sarici, I. S., Sivrikoz, E., Ucar, A., Yanar, H., Aksoy, M., & Kurtoglu, M.
- Affiliations
- Istanbul University (TR)
- Bahçeşehir University (TR)
- Corresponding author
- Yanar, Fatih
- Venue
- World Journal of Emergency Surgery
- Published
- 2013
- Volume
- 8
- Issue
- 1
- Pages
- 8
- ISSN
- 1749-7922 (ISSN-L)
- PMC
- PMC3626770
- OpenAlex
- W2145447504
- Cited by
- 19
- References
- 18
- Citations by year
- 2025: 4 · 2023: 1 · 2022: 2 · 2020: 1 · 2019: 1 · 2018: 2 · 2017: 4 · 2016: 1 · 2014: 3
- FWCI
- 1.31
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- World Journal of Emergency Surgery (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Emergency Medicine › Appendicitis Diagnosis and Management
- Health Sciences › Medicine › Surgery › Intestinal and Peritoneal Adhesions
- Keywords
- acute mesenteric ischemia, local thrombolytic therapy, recombinant plasminogen activator, laparoscopy, CT angiography, thromboembolectomy, early intervention, mortality, acute arterial occlusion
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