Abstract

LOPES, Simão  and  DONATO, Paulo. Endovascular Therapy in Acute Mesenteric Ischemia. Acta Radiol Port [online]. 2023, vol.35, n.1, pp.10-18.  Epub Apr 30, 2023. ISSN 2183-1351.  https://doi.org/10.25748/arp.24477.

Background: Acute mesenteric ischemia is a cause of acute abdomen associated with high morbidity and mortality rates. Current recommendations for the initial treatment include endovascular or surgical revascularization, however they are based on small retrospective studies. The objective of this study is to review the available endovascular treatment techniques evaluating their results.

Methods: In August 2020, a survey of the last 15 years was conducted in the PubMed and EMBASE databases using the keywords "Mesenteric Ischemia [MeSH]", "Acute Disease [MeSH]", "Endovascular Procedures [MAJR]", "Thrombectomy [MeSH]" and "Thrombolysis". Review articles, systematic reviews and meta-analyses, guidelines, case studies and opinion articles, studies that did not present at least one of the intended outcomes (technical success, clinical success, recurrence rate, complications, and mortality rates) and articles on arterial mesenteric ischemia with a sample of less than 10 (n < 10) were excluded.

Results: Among 482 records initially surveyed, 19 studies were included in this review, 14 referring to arterial acute mesenteric ischemia of and 5 to venous acute mesenteric ischemia. Technical success rates ranged from 81 to 100% in arterial etiology and were 100% in venous etiology, with clinical success ranging from 53% to 71,4% in arterial etiology and between 87,5% to 100% venous etiology. Early mortality rates ranged from 9,5% to 44,7% in artery etiology and between 0% to 12,5% in venous etiology.

Conclusions: The use of endovascular techniques proved to be a viable option in the context of acute mesenteric ischemia, contributing to an improvement in the outcomes of this entity that continues to be related to a poor prognosis.

Keywords : Mesenteric ischemia [MeSH]; Acute disease [MeSH]; Endovascular procedures [MAJR]; Thrombectomy [MeSH]; Thrombolysis..

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