TY - JOUR T1 - Acute Mesenteric Ischemia: Utility of Endovascular Techniques JO - Cirugía Española (English Edition) T2 - AU - Serracant Barrera,Anna AU - Luna Aufroy,Alexis AU - Hidalgo Rosas,José Manuel AU - Cánovas Moreno,Gabriel AU - Fortuño Andres,José Ramón AU - Falcó Fages,Joan AU - Navarro Soto,Salvador SN - 21735077 M3 - 10.1016/j.cireng.2015.07.001 DO - 10.1016/j.cireng.2015.07.001 UR - https://www.elsevier.es/en-revista-cirugia-espanola-english-edition--436-articulo-acute-mesenteric-ischemia-utility-endovascular-S2173507715002689 AB - IntroductionAcute mesenteric ischemia (AMI) has a high mortality. Early diagnosis and treatment are very important. In our institution there is a therapeutic protocol that includes endovascular techniques (ET) in patients with AMI without peritoneal irritation at diagnosis. The aim of this study was to evaluate the use of ET in conjunction with conventional surgery in the management of potentially reversible IMA diagnosed by computed tomography (CT-angiography). MethodsObservational, descriptive and retrospective study that evaluated the use of ET in patients with AMI (arterial origin) in two periods (before and after the application of a protocol that includes ET), between 2009 and 2013. All patients were diagnosed by a CT-angiography, as the diagnostic technique of choice, because of the clinical and analytical suspicion. ResultsOur series included 73 patients with IMA diagnosed by CT-angiography (45: 2009–2011; 28: 2012–2013). Leukocytosis was common (82%), high lactate levels are less frequent (47% vs 53%). There were 49 patients with IMA without peritoneal irritation. In 51% bowel resection surgery was performed (44% survival); 18%: revascularization by ET (survival 67%); 31%: palliative treatment (0% survival). 33% of patients undergoing first-line RVI needed a surgical rescue (bowel resection). The overall mortality was 67% (2009–2011) vs 62% (2012–2013). ConclusionsSince the protocol application, there is a higher indication of ET in patients with AMI without peritoneal irritation, showing a decreased mortality. With ET application, there is a higher survival in these patients. In our experience, the use of ET in cases of AMI without peritoneal irritation at diagnosis, may increase survival. ER -