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Interventional Treatment Of Mesenteric Venous Occlusion

Di: Ava

Nonocclusive mesenteric ischemia is a serious condition caused by reduced blood flow to the intestines, requiring prompt diagnosis and treatment. Mesenteric venous occlusion can be adequately assessed by contrast-enhanced CT or MRI. In cases where these noninvasive diagnostic modalities do not provide a de finitive answer, CT arterial portography may be helpful in delineating mesenteric venous anatomy [10].

Journal of Trauma and Acute Care Surgery

Management of mesenteric vascular occlusion | PPT

Veno-occlusive mesenteric ischemia is most often the result of superior mesenteric vein (SMV) thrombosis and is a less common cause of acute mesenteric ischemia. Despite thrombosis of the SMV, small bowel necrosis often does not occur, presumably due to persistent arterial supply and some venous drainage via collaterals. Background Endovascular therapy, including aspiration thrombectomy and local thrombolytic therapy, often associated with angioplasty and stent placement, has been described in the literature. The purpose of this study was to review case series of patients with acute mesenteric ischemia treated with endovascular therapy and evaluate their outcomes. Most reported treatments for mesenteric arteriovenous malformations (AVMs) involve arterial-side embolization with possible mesenteric resection upon failure [2]. However, they achieved a successful outcome by adding venous embolization.

The present report describes two cases of chronic lower gastrointestinal bleeding caused by systemic-to-mesenteric venous collateral vessels resulting from longstanding inferior vena cava obstruction. They were successfully treated with caval balloon angioplasty and stent placement. No recurrent bleeding was seen at 15 and 24 months of follow up, respectively. We describe the case of a moderately long chronic superior mesenteric vein (SMV) occlusion following Whipple procedure. Anticoagulation therapy and traditional recanalization techniques through retrograde approach, collateral inferior mesenteric venous vasculature, and recanalization upstream of the SMV occlusion via direct transabdominal puncture failed. Sharp recanalization

Acute mesenteric ischaemia (AMI) is an abdominal emergency in which an acute reduction in mesenteric arterial supply threatens bowel viability and may result in bowel infarction, perforation, and death. Despite improvements in diagnosis and treatment over recent decades, mortality rates in AMI remain very high. This article discusses the aetiological classification, Acute mesenteric ischaemia is a serious condition affecting mainly elderly patients with a high mortality rate, but the diagnosis of mesenteric ischaemia is not an automatic death sentence.

Thus, consultation with the general surgery specialist and interventional radiologist is recommended. Patients with mesenteric venous thrombosis may only require anticoagulation acutely, though up to 5% of patients require further intervention (e.g., the diagnosis of acute mesenteric ischemia is multiphasic contrast-enhanced CT including unenhanced, early arterial and portal venous phase images. As well as enabling correct diagnosis, CT bears a prognostic role.

  • Interventional Treatment of Acute Portal Vein Thrombosis
  • Acute mesenteric ischaemia in the elderly
  • Mesenteric Venous Thrombosis
  • Acute mesenteric ischemia: A critical role for the radiologist

In animal models, gradual occlusion of the superior mesenteric vein is associated with the development of collateral venous drainage without ischemic damage [10]. Chronic mesenteric venous thrombosis often features dilated venous collaterals, which can bleed, due to elevated venous pressures [11].

Portal venous thrombosis and stenosis are uncommon but serious causes of liver transplant graft failure. While surgical thrombectomy can be utilized for the treatment of portal steno-occlusive disease, venous interventions with IR

Modern treatment of acute mesenteric ischaemia

Diagnosis of acute mesenteric ischaemia in the early stages is now possible with modern computed tomography (CT), using intravenous contrast enhancement and imaging in the arterial and/or portal venous phase. The availability of CT around the clock means that more patients with acute mesenteric ischaemia may be treated with urgent intestinal revascularization.

AMI may result from embolic occlusion, most commonly in the superior mesenteric artery (SMA), thrombotic occlusion in the presence of underlying pathology, such as atherosclerosis or dissection, or it may have non-occlusive etiology, such as splanchnic vasoconstriction or spasm, or mesenteric venous thrombotic occlusion [1, 2]. Causes of mesenteric ischemia may be arterial (eg, thromboembolism, atherosclerosis, dissection, and vasculitis), mesenteric venous thrombosis, and hypoperfusion (eg, hypovolemia, shock). The purpose of imaging evaluation is to determine the underlying cause of bowel ischemia, which then helps direct treatment decisions.

Pathophysiology Acute Mesenteric Ischemia Acute mesenteric ischemia (AMI) is a serious and life-threatening condition. Common etiologies include mesenteric arterial embolus (embolic AMI), mesenteric arterial thrombosis (thrombotic AMI), mesenteric and/or portal venous thrombosis, and nonocclusive mesenteric ischemia (NOMI). Extrahepatic mesocaval shunts were successfully created in three patients with refractory variceal hemorrhage, complete portal vein or superior mesenteric vein occlusion, and contraindications to shunt surgery. The use of intravascular ultrasound guidance and covered stents allowed safe and effective transvenous shunt creation without the necessity of

Mesenteric ischemia, also commonly referred to as bowel or intestinal ischemia, refers to vascular compromise of the bowel and its mesentery that in the acute setting has a very high mortality if not treated expediently. Mesenteric ischemia is fa

Acute mesenteric ischaemia: imaging and intervention

Mesenteric venous thrombosis (MVT) describes acute, subacute, or chronic thrombosis of the superior or inferior mesenteric vein or branches. MVT may present with acute abdominal pain or may be an asymptomatic incidental finding on abdominal imaging. MVT accounts for 1 in 5000 to 15 000 inpatient admissions and 1 in 1000 emergency surgical The pathophysiology and clinical presentation of AMI depend on the type of AMI (arterial occlusion, mesenteric venous thrombosis, non-occlusive ischaemia (NOMI)). AMI is a multistep time-dependent process involving vascular insufficiency, followed by an ischemic damage to the bowel wall starting from mucosal side and associated with bacterial Abstract Extrahepatic mesocaval shunts were successfully created in three patients with refractory variceal hemorrhage, complete portal vein or superior mesenteric vein occlusion, and contraindications to shunt surgery. The use of intravascular ultrasound guidance and covered stents allowed safe and effective transvenous shunt creation without the necessity of

Background Acute superior mesenteric vein thrombosis (ASMVT) is a rare but life-threatening condition associated with high morbidity and mortality. While anticoagulation remains the standard treatment, endovascular therapies such as thrombolysis, thrombectomy, and angioplasty are increasingly utilized in selected cases. However, evidence on their outcomes While endovascular therapies are more well-established in treating chronic mesenteric ischemia, they are also becoming increasingly popular in treating acute mesenteric ischemia. This review delves into the pathogenesis, clinical characteristics, classification, imaging, and minimally invasive endovascular therapies for mesenteric

CTAP provided excellent opacification and delineation of portomesenteric veins, including occlusion length, intravascular webs, venous collaterals, and bleeding varices. This enabled preoperative planning for complex recanalization or extra-anatomic bypass to treat extrahepatic portal and mesenteric venous obstruction.

  • Nonocclusive mesenteric ischemia
  • Superior mesenteric venous thrombosis
  • Imaging and endovascular interventions in mesenteric ischaemia
  • Journal of Trauma and Acute Care Surgery
  • Mesenteric venous thrombosis in adults

Mesenteric venous thrombosis (MVT) describes acute, subacute, or chronic thrombosis of the superior or inferior mesenteric vein or branches.

Male Mesenteric Vascular Occlusion / diagnostic imaging Mesenteric Vascular Occlusion / therapy* Middle Aged Pain Measurement Portal Vein Punctures Radiography, Interventional / methods Thrombectomy / methods* Thrombolytic Therapy / methods* Tomography, X-Ray Computed / methods Treatment Outcome Ultrasonography Venous Thrombosis / diagnostic Superior mesenteric venous thrombosis can result from a number of conditions. It can account for around 5-15% of all mesenteric ischemic events.

Initiation of systemic anticoagulation is the mainstay of treatment for mesenteric venous occlusion. In patients who demonstrate failure with anticoagulation, indirect thrombolytic infusion into the mesenteric veins via a SMA infusion can be considered as adjunctive therapy. Authors report the use of computed tomography arterioportography (CTAP) in the diagnosis and endovascular treatment of portomesenteric venous occlusion. Three patients (2 male and 1 female; median age: 51 years) with an extrahepatic portal or mesenteric venous occlusion and variceal bleeding were included in this institutional review boards-approved retrospective Abstract Risk factors for acute venous occlusion range from prolonged immobilization to hypercoagulability syndromes, trauma, and malignancy. The aim of this review article is to illustrate the different imaging options for the diagnosis of acute venous occlusion and to assess the value of interventional strategies for venous thrombosis treatment in an emergency

Background Chronic total occlusion (CTO) of the portal vein is one of the main causes of portal hypertension, which may result in life-threatening complications often managed by interventional radiology (IR). The aim of this study is to report the innovative experience with percutaneous revascularization therapy in the management of portal vein CTO in paediatric Background: Acute portal vein thrombosis is a potentially fatal condition. In symptomatic patients not responding to systemic anticoagulation, interventional procedures have emerged as an alternative to surgery. This study sought to retrospectively evaluate initial results of interventional treatment of acute portal vein thrombosis (aPVT) using a transjugular interventional approach.

Over the last decade, JAK-2 (janus kinase 2) mutation has emerged as an accurate biomarker for diagnosis of myeloproliferative neoplasm, an important cause for mesenteric venous thrombosis. Anticoagulation is the treatment of choice for acute mesenteric venous thrombosis. Thrombolysis using systemic or transcatheter route is another option. Diagnosis and treatment of intestinal ischemia (mesenteric venous thrombosis and major nonembolic arterial occlusion). Solid lines indicate accepted management plan; dashed lines indicate alternate management plan. Abstract Objectives The transjugular intrahepatic portosystemic shunt procedure remains technically challenging in cases involving occlusion of the portal trunk. This study aimed to evaluate the feasibility, efficacy, and safety of utilizing the inferior vena cava-splenic vein shunt (IVCSS) as a new treatment option in cirrhotic patients with complete portal trunk occlusion

Mesenteric vascular insufficiency is a serious medical condition that may lead to bowel infarction, morbidity, and mortality that may approach 50%. Recommended therapy for acute mesenteric ischemia includes aspiration embolectomy, transcatheter thrombolysis, and angioplasty with or without stenting for the treatment of underlying arterial stenosis. Nonocclusive mesenteric Abstract: Acute mesenteric arterial occlusion, resulting from impaired blood flow in the superior mesenteric artery, is classified into embolism and thrombosis; both conditions lead to rapid intestinal ischemia, with a high mortality rate of >30% within 30 days. A multidisciplinary treatment approach, including prompt revascularization, necrotic intestinal tract resection, intensive