OBJECTIVE: To evaluate the effect of selective intramesenteric artery vasodilator infusion on intestinal viability in a rat model of acute segmental mesenteric vascular occlusion. SUMMARY BACKGROUND DATA: Although intramesenteric arterial vasodilator infusion may be an effective treatment for nonocclusive mesenteric ischemia, it has also been advocated to increase collateral blood flow after mesenteric vascular occlusion. However, the authors have previously found that intraarterial vasodilators actually reduce collateral blood flow acutely, by preferentially dilating the vasculature of adjacent, nonischemic mesenteric vascular beds, a phenomenon well established in other organs. METHODS: A segment of rat ileum was acutely devascularized, with blood flow provided only by collateral arterial vessels from adjacent, nonischemic bowel. Papaverine (30 or 40 microg/kg/min), isoproterenol (0.06 microg/kg/min), norepinephrine (0.1 or 0.2 microg/kg/min), or vehicle saline was continuously infused into the cranial (superior) mesenteric artery for 48 hours. Viability was then assessed using previously established, objective gross and microscopic criteria. RESULTS: Although papaverine increased total mesenteric blood flow in normally vascularized rats, it not only failed to improve but actually significantly reduced the length of the devascularized segment maintained viable by collateral blood flow after 48 hours. Isoproterenol had a similar effect. Norepinephrine infusion decreased both normal mesenteric blood flow and viable segment length. CONCLUSIONS: These findings suggest that intraarterial vasodilator therapy fails to improve intestinal viability after segmental mesenteric vascular occlusion.
OBJECTIVE: To evaluate the effect of selective intramesenteric artery vasodilator infusion on intestinal viability in a rat model of acute segmental mesenteric vascular occlusion. SUMMARY BACKGROUND DATA: Although intramesenteric arterial vasodilator infusion may be an effective treatment for nonocclusive mesenteric ischemia, it has also been advocated to increase collateral blood flow after mesenteric vascular occlusion. However, the authors have previously found that intraarterial vasodilators actually reduce collateral blood flow acutely, by preferentially dilating the vasculature of adjacent, nonischemic mesenteric vascular beds, a phenomenon well established in other organs. METHODS: A segment of rat ileum was acutely devascularized, with blood flow provided only by collateral arterial vessels from adjacent, nonischemic bowel. Papaverine (30 or 40 microg/kg/min), isoproterenol (0.06 microg/kg/min), norepinephrine (0.1 or 0.2 microg/kg/min), or vehicle saline was continuously infused into the cranial (superior) mesenteric artery for 48 hours. Viability was then assessed using previously established, objective gross and microscopic criteria. RESULTS: Although papaverine increased total mesenteric blood flow in normally vascularized rats, it not only failed to improve but actually significantly reduced the length of the devascularized segment maintained viable by collateral blood flow after 48 hours. Isoproterenol had a similar effect. Norepinephrine infusion decreased both normal mesenteric blood flow and viable segment length. CONCLUSIONS: These findings suggest that intraarterial vasodilator therapy fails to improve intestinal viability after segmental mesenteric vascular occlusion.
Authors: Miklosh Bala; Fausto Catena; Jeffry Kashuk; Belinda De Simone; Carlos Augusto Gomes; Dieter Weber; Massimo Sartelli; Federico Coccolini; Yoram Kluger; Fikri M Abu-Zidan; Edoardo Picetti; Luca Ansaloni; Goran Augustin; Walter L Biffl; Marco Ceresoli; Osvaldo Chiara; Massimo Chiarugi; Raul Coimbra; Yunfeng Cui; Dimitris Damaskos; Salomone Di Saverio; Joseph M Galante; Vladimir Khokha; Andrew W Kirkpatrick; Kenji Inaba; Ari Leppäniemi; Andrey Litvin; Andrew B Peitzman; Vishal G Shelat; Michael Sugrue; Matti Tolonen; Sandro Rizoli; Ibrahima Sall; Solomon G Beka; Isidoro Di Carlo; Richard Ten Broek; Chirika Mircea; Giovanni Tebala; Michele Pisano; Harry van Goor; Ronald V Maier; Hans Jeekel; Ian Civil; Andreas Hecker; Edward Tan; Kjetil Soreide; Matthew J Lee; Imtiaz Wani; Luigi Bonavina; Mark A Malangoni; Kaoru Koike; George C Velmahos; Gustavo P Fraga; Andreas Fette; Nicola de'Angelis; Zsolt J Balogh; Thomas M Scalea; Gabriele Sganga; Michael D Kelly; Jim Khan; Philip F Stahel; Ernest E Moore Journal: World J Emerg Surg Date: 2022-10-19 Impact factor: 8.165
Authors: Carlos Pérez-García; Enrique de Miguel Campos; Adriana Fernández Gonzalo; Carlos Malfaz; Jesus Javier Martín Pinacho; Carmen Fernández Álvarez; Raquel Herranz Pérez Journal: Br J Radiol Date: 2017-10-27 Impact factor: 3.039
Authors: Miklosh Bala; Jeffry Kashuk; Ernest E Moore; Yoram Kluger; Walter Biffl; Carlos Augusto Gomes; Offir Ben-Ishay; Chen Rubinstein; Zsolt J Balogh; Ian Civil; Federico Coccolini; Ari Leppaniemi; Andrew Peitzman; Luca Ansaloni; Michael Sugrue; Massimo Sartelli; Salomone Di Saverio; Gustavo P Fraga; Fausto Catena Journal: World J Emerg Surg Date: 2017-08-07 Impact factor: 5.469