Management of Acute Intestinal Ischaemia
Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams in Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Patients with mesenteric venous thrombosis often have a less acute presentation as compared with arterial embolism or thrombosis. Symptoms often develop gradually over a period of days. Similar to arterial embolism or thrombosis, patients often have pain out of proportion to the exam. In addition to abdominal pain, patients may experience anorexia and diarrhoea.7 Similar to the other forms of mesenteric ischaemia, CT imaging is often the main stay diagnostic modality. However, the accurate diagnosis of mesenteric venous thrombosis requires delayed venous phase images to properly assess the venous system. Except in the setting of peritonitis, the management of venous thrombosis is often non-surgical and involves systemic anticoagulation, bowel rest and close observation.
Acute Mesenteric Ischemia
Stephen M. Cohn, Peter Rhee in 50 Landmark Papers, 2019
Knowing the etiology of AMI plays a key role in patient management and outcomes. It is important to acknowledge two important studies with differences in etiologies for AMI. In a classical analysis by Endean (2001), AMI was diagnosed in 170 patients. The most common etiology was nonthrombotic (60%), followed by thrombotic (34%), and indeterminate (6%). In the thrombotic cohort, arterial embolism accounted for 38%, arterial thrombosis for 36%, and venous thrombosis for 26%. This is in contrast to a more recent study of 107 patients with AMI by Alhan et al. (2012) where the most common etiology was documented to be mesenteric arterial thrombosis (63.6%), followed by arterial embolism (26%), and nonocclusive mesenteric ischemia (10.2%). Although differences in etiologies exist based on current literature, it is important to remember the difference in outcomes based on origin of AMI, as demonstrated by Schoots et al. (2004), who performed a quantitative analysis of data derived from 45 observational studies containing 3692 patients. They were able to identify that survival after AMI varied between the different etiological subsets. The authors concluded that the mortality rate after surgical treatment of arterial embolism and venous thrombosis has improved over the years, whereas that after surgery for arterial thrombosis and nonocclusive ischemia remained poor.
Endovascular management of splanchnic artery aneurysms
Sachinder Singh Hans, Alexander D Shepard, Mitchell R Weaver, Paul G Bove, Graham W Long in Endovascular and Open Vascular Reconstruction, 2017
Treatment for SAAs includes open surgical repair or endovascular repair. Open surgery for SAAs can carry a 1-3% mortality rate, together with a 9-25% perioperative complication rate from splenic or pancreatic injury.5, 8 Additionally, surgery for SAAs due to pancreatitis has an associated mortality rate of 30% because of the technical problems associated with persistent intra-abdominal sepsis, the presence of extensive inflammatory adhesions, pancreatic pseudocysts, multiple feeding vessels, and enteric erosions, as well as the possible need for splenectomy and partial pancreatectomy.5 Therefore, percutaneous arterial embolism and thrombosis of the aneurysm is preferable and safer.
Rat hippocampal CA3 neuronal injury induced by limb ischemia/reperfusion: A possible restorative effect of alpha lipoic acid
Published in Ultrastructural Pathology, 2018
Ola A. Hussein, Amel M. M. Abdel-Hafez, Ayat Abd el Kareim
Different ischemic models were used in various studies. Each model simulates a different clinical situation that may contribute to discrepancy of responses. In our work, the model of limb ischemia was done by clamping of bilateral femoral arteries for 3 h, with reperfusion for 1 day (group II) or for 7 days (group III). Although this method is more traumatic, yet it is the ideal model for the total elimination of collateral circulation. This model only involves arterial irrigation, leaving venous drainage intact, and is considered more appropriate to simulate an arterial embolism.22 In biomedical literature, there are other models used to produce tissue ischemia. The most suitable model for simulating compression trauma or the surgical procedure of tourniquet application used in orthopedic operations is the use of the experimental tourniquet, which involves arterial irrigation and venous drainage simultaneously.23
Comparison of predictive value of risk scores for gastrointestinal bleeding in antiplatelet therapy
Published in Platelets, 2022
Mei-na Lv, Xiao-chun Zheng, Shao-jun Jiang, Hong-qin Zhang, Fang-Da Xu, Ting-Ting Wu, Wen-Jun Chen, Jin-hua Zhang
With the increased aging of the population, the prevalence of cardiovascular and cerebrovascular diseases is increasing year by year. According to the survey, there are currently about 290 million patients with cardiovascular and cerebrovascular diseases in China, accounting for about 21% of the total population [1,2], and the standardized incidence of stroke among residents aged 40–74 has increased by an average of 8.3% per year [3]. Antiplatelet drugs are one of the important drugs for the prevention and treatment of cardiovascular and cerebrovascular diseases. The use of antiplatelet drugs is also increasing year by year in China. For example, the amount of clopidogrel used in 2018 increased by 1.89 times compared with 2013 [4]. Oral antiplatelet drugs mainly include aspirin, clopidogrel, ticagrelor, cilostazol, and prasugrel. These drugs are widely used to prevent or treat thrombosis and reduce the risk of embolism events, including non-cardiogenic stroke, coronary heart disease, and lower extremity arterial embolism [5–7].
Diagnosis of coronary artery disease: potential complications of imaging techniques
Published in Acta Cardiologica, 2022
Evangelos Sdogkos, Andrew Xanthopoulos, Grigorios Giamouzis, John Skoularigis, Filippos Triposkiadis, Ioannis Vogiatzis
Acute systemic complications during invasive procedures are rare. The risk of death is increased in patients with depressed left ventricular systolic performance or cardiogenic shock, in those with multivessel or left main artery disease, and in the elderly. The detachment of sections of friable vascular plaques may cause a peripheral arterial embolism in remote organs. Cerebral artery embolism is the most frequent, causing either transient or permanent ischaemic stroke. An acute myocardial infarction can be induced, either by coronary artery embolism or by the dissection of the coronary artery ostium. Additionally, dissection and perforation of the great vessels are both serious complications that may occur in patients with severe atherosclerosis [2].
Related Knowledge Centers
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