OBJECTIVE: This study aims to analyze the diagnostic workup in patients referred for endovascular mesenteric revascularization for symptomatic mesenteric atherosclerotic disease. MATERIAL AND METHODS: Fifty-five patients were identified between 2006 and 2011. Median follow-up time was 24 months. RESULTS: Median age was 71 years, 67 % were women. Forty patients had acute on chronic mesenteric ischemia, eight had acute mesenteric ischemia, and seven had chronic mesenteric ischemia. Other manifestations of atherosclerotic disease were present in 71 %. Body mass index (BMI) <20 kg/m(2) was found in 37 %. Endoscopy diagnosed duodenitis (38 %; 13/34) and colitis in the right colon (57 %;12/21). All ulcers tested for Helicobacter pylori were negative (n = 17). Patients received proton pump inhibitor, antibiotic, and cortisone therapy during diagnostic workup in 73, 42, and 29 % of the cases, respectively. Previous hospitalization for the same complaints had occurred in 78 %. CT angiography showed occlusion (n = 30) and high-grade stenosis (n = 25) of the superior mesenteric artery (SMA). Forty-eight patients were treated with stenting of the SMA. The BMI increased in both women (p = 0.001) and men (p = 0.03) after endovascular therapy. The in-hospital mortality rate was 18 %. CONCLUSION: Patients with abdominal pain, known atherosclerotic disease, right-sided colitis or H. pylori-negative duodenitis should undergo CT angiography immediately to be able to identify symptomatic mesenteric atherosclerotic disease.
OBJECTIVE: This study aims to analyze the diagnostic workup in patients referred for endovascular mesenteric revascularization for symptomatic mesenteric atherosclerotic disease. MATERIAL AND METHODS: Fifty-five patients were identified between 2006 and 2011. Median follow-up time was 24 months. RESULTS: Median age was 71 years, 67 % were women. Forty patients had acute on chronic mesenteric ischemia, eight had acute mesenteric ischemia, and seven had chronic mesenteric ischemia. Other manifestations of atherosclerotic disease were present in 71 %. Body mass index (BMI) <20 kg/m(2) was found in 37 %. Endoscopy diagnosed duodenitis (38 %; 13/34) and colitis in the right colon (57 %;12/21). All ulcers tested for Helicobacter pylori were negative (n = 17). Patients received proton pump inhibitor, antibiotic, and cortisone therapy during diagnostic workup in 73, 42, and 29 % of the cases, respectively. Previous hospitalization for the same complaints had occurred in 78 %. CT angiography showed occlusion (n = 30) and high-grade stenosis (n = 25) of the superior mesenteric artery (SMA). Forty-eight patients were treated with stenting of the SMA. The BMI increased in both women (p = 0.001) and men (p = 0.03) after endovascular therapy. The in-hospital mortality rate was 18 %. CONCLUSION:Patients with abdominal pain, known atherosclerotic disease, right-sided colitis or H. pylori-negative duodenitis should undergo CT angiography immediately to be able to identify symptomatic mesenteric atherosclerotic disease.
Authors: Tiziano Tallarita; Gustavo S Oderich; Thanila A Macedo; Peter Gloviczki; Sanjay Misra; Audra A Duncan; Manju Kalra; Thomas C Bower Journal: J Vasc Surg Date: 2011-10-02 Impact factor: 4.268
Authors: Jussi M Kärkkäinen; Petri Saari; Hannu-Pekka Kettunen; Tiina T Lehtimäki; Ritva Vanninen; Hannu Paajanen; Hannu Manninen Journal: J Gastrointest Surg Date: 2015-11-09 Impact factor: 3.452
Authors: Luke G Terlouw; Adriaan Moelker; Jan Abrahamsen; Stefan Acosta; Olaf J Bakker; Iris Baumgartner; Louis Boyer; Olivier Corcos; Louisa Jd van Dijk; Mansur Duran; Robert H Geelkerken; Giulio Illuminati; Ralph W Jackson; Jussi M Kärkkäinen; Jeroen J Kolkman; Lars Lönn; Maria A Mazzei; Alexandre Nuzzo; Felice Pecoraro; Jan Raupach; Hence Jm Verhagen; Christoph J Zech; Desirée van Noord; Marco J Bruno Journal: United European Gastroenterol J Date: 2020-04-16 Impact factor: 4.623