Protocolo diagnóstico y terapéutico de las lesiones de las arterias mesentéricas

  1. Valverde García, S. 1
  2. Peña Cortés, R. 1
  3. Torres Hernández, J.A. 1
  4. Lozano Sánchez, F.S. 1
  1. 1 Servicio de Angiología y Cirugía Vascular, Hospital Universitario de Salamanca, Salamanca, España Departamento de Cirugía, Universidad de Salamanca, Salamanca, España
Journal:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Year of publication: 2021

Issue Title: Enfermedades cardiovasculares (V)

Series: 13

Issue: 39

Pages: 2280-2285

Type: Article

DOI: 10.1016/J.MED.2021.08.005 DIALNET GOOGLE SCHOLAR

More publications in: Medicine: Programa de Formación Médica Continuada Acreditado

Abstract

Mesenteric ischaemia is due to reduced blood flow at the level of the intestine. It is life-threatening if prolonged over time. The clinical manifestations of this entity are non-specific and not usually visible until advanced stages of intestinal necrosis. Therefore, remembering the risk factors and maintaining a high rate of suspicion is essential for its prognosis. Imaging techniques such as CT angiography and angiography (which in some cases will allow therapeutic interventions) are required for diagnosis. Early revascularisation is essential. Endovascular treatment is constantly evolving, increasingly safe and has more indications, yet open surgery is essential to manage mesenteric ischaemia. It is recommended, therefore, that patients with mesenteric ischaemia be assessed and treated in specialist centres that can offer multidisciplinary assessment, and open and endovascular treatment.

Bibliographic References

  • Björck M, Koelemay M, Acosta, S Bastos Goncalves F, Kölbel T, Kolkman JJ. Management of the diseases of mesenteric arteries and veins. Clinical Practice Guidelines of the European Society of Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2017;53(4): 460-510.
  • Zhao Y, Yin H, Yao C, Deng J, Wang M, Li Z. Management of acute mesenteric ischemia: a critical review and treatment algorithm. Vasc Endovascular Surg. 2016;50(3):183-92.
  • Kirkpatrick AW, Roberts DJ, De Waele J, Jaeschke R, Malbrain ML, De Keulenaer B. Intraabdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Com-partment Syndrome. Intensive Care Med. 2013;39(7): 1190-206.
  • Riambau V, Böckler D, Brunkwall J, Cao P, Chiesa R, Coppi G. Management of descending thoracic aorta diseases. Clinical practice guidelines of the European Society for Vascular Surgery. Eur J Vasc Endovasc Surg. 2017;53(1):4-52.
  • Pecoraro F, Rancic Z, Lachat M, Mayer D, Amann Vesti B, Pfammatter T. Chronic mesenteric ischemia: critical review and guidelines for management. Ann Vasc Surg. 2013;27(1):113-22.
  • Alahdab F, Arwani R, Pasha AK, Prokop LJ, Huber, TS Murad. MH A systematic review and meta analysis of endovascular versus open surgical revascularization for chronic mesenteric ischemia. J Vasc Surg. 2018;67(5):1598-605.