Right-Side Colon Ischemia: Clinical Features, Large Visceral Artery Occlusion, and Long-Term Follow-Up
Open accessAbstract
CONTEXT: Large visceral artery occlusion (LVAO) could underlie right-side colon ischemia (RSCI) but is little known. OBJECTIVE: To assess patients with RSCI through long-term follow-up, including features and management of LVAO. MAIN OUTCOME MEASURES: Mesenteric ischemia and mortality. DESIGN: Retrospective observational study in an integrated health care system. RESULTS: Of 49 patients (30 women [61.2%]; mean [standard deviation] age, 69.4 [11.9] years), 19 (38.8%) underwent surgery—that is, 5 (83.3%) of 6 who developed RSCI in hospital following surgical procedures and 14 (32.6%) of 43 who had RSCI before hospitalization (p value = 0.03); overall, 5 (10.2%) died. Among 44 survivors with a median (range) follow-up of 5.19 (0.03-14.26) years, 5 (11.4%), including 3 (20.0%) of 15 operated cases, had symptomatic LVAO and underwent angioplasty and stent placement: 2 for abdominal angina that preceded RSCI, 1 for acute mesenteric ischemia 1 week after resection of RSCI, 1 for RSCI 6 weeks after resection of left-side ischemia, and 1 for abdominal angina that began 3 years after spontaneous recovery from RSCI. None had further mesenteric ischemia until death from nonintestinal disease or the end of follow-up (1.6 to 10.2 years later). Kaplan-Meier survival estimates for all 44 survivors at 1, 3, 5, and 10 years were 88.6%, 72.3%, 57.6%, and 25.9%, respectively. Thirty-one patients (70.4%) died during follow-up, 19 (61.3%) of a known cause; the 39 patients not treated for LVAO lacked mesenteric ischemia. CONCLUSION: Patients with RSCI may have symptomatic LVAO; therefore, we advise they undergo careful query for symptoms of abdominal angina and routine visceral artery imaging.
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Patients with right-sided CI (RSCI) can have large visceral artery occlusion.
“But as patients with right-sided CI (RSCI) can have large visceral artery occlusion, CTA should be done in case of suspected RSCI or when the diagnosis of AMI needs to be ruled out[76].”
From Ischemic bowel disease in 2021. (2021) · cites this paper as [76]
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Ischemic bowel disease in 2021.
Ahmed, M. (2021) · World Journal of Gastroenterology · doi:10.3748/wjg.v27.i29.4746 · Cited by 77 · see citing works
- Authors
- Longstreth, G. F., & Hye, R. J.
- Affiliations
- University of California San Diego Medical Center (US)
- Vascular Surgeon in the Department of Surgery at the San Diego Medical Center and the Chair of the San Diego Area Research Committee for the Southern California Permanente Medical Group..
- Venue
- The Permanente Journal
- Publisher
- The Permanente Federation
- Published
- 2015-12
- Volume
- 19
- Issue
- 4
- Pages
- 11-16
- ISSN
- 1552-5767 (ISSN-L)
- 1552-5775
- PMC
- PMC4625989
- OpenAlex
- W2433538255
- Cited by
- 8
- References
- 30
- Citations by year
- 2021: 3 · 2019: 2 · 2018: 1 · 2016: 1 · 2015: 1
- FWCI
- 1.01
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Permanente Journal (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Aortic Thrombus and Embolism
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Renal and Vascular Pathologies
- Keywords
- mesenteric ischemia, abdominal angina, long-term survival, mortality, postoperative complications
- MeSH terms
- Aged, Aged, 80 and over, Colon, Female, Humans, Male, Mesenteric Vascular Occlusion, Middle Aged, Retrospective Studies, Risk Factors, Comorbidity, Mesenteric Ischemia
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