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Visualization of Neutrophil Extracellular Traps in Mesenteric Venules After Mesenteric Ischemia-Reperfusion Injury via Intravital Microscopy
Published on: September 27, 2024
Local thrombolytic therapy in acute mesenteric ischemia
Fatih Yanar1, Orhan Agcaoglu, Inanc Samil Sarici
1Istanbul Medical Faculty, Department of General Surgery, Istanbul University, Istanbul, Turkey. yanar_fatih@yahoo.com.
World Journal of Emergency Surgery : WJES
|February 12, 2013
Summary
Local thrombolytic therapy (LTT) combined with laparoscopy shows potential for managing acute mesenteric ischemia (AMI). Early intervention is crucial for improving patient outcomes in AMI cases.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Gastroenterology
Background:
- Acute mesenteric ischemia (AMI) poses significant management challenges.
- Evaluating the efficacy of local thrombolytic therapy (LTT) in conjunction with surgical intervention for AMI.
Purpose of the Study:
- To assess the combined use of LTT and laparoscopy for acute mesenteric ischemia.
- To determine the impact of early diagnostic and therapeutic interventions on AMI outcomes.
Main Methods:
- Retrospective analysis of 76 patients with AMI due to acute arterial occlusion (January 2000-January 2010).
- Computerized tomography angiography (CTA) for diagnosis, followed by selective mesenteric angiography and LTT.
- LTT administered before or after laparoscopy/laparotomy, utilizing recombinant plasminogen activator.
Main Results:
- LTT was performed in 13 patients (17.1%); 56 underwent bowel resection, 7 had thromboembolectomy.
- Median symptom duration was 24 hours; 30.7% presented within 24 hours, 69.3% after.
- Mortality was 20% in patients without peritoneal signs versus 62.5% in those with peritoneal signs.
Conclusions:
- Early intervention is critical for improving outcomes in acute mesenteric ischemia.
- The combination of CTA, early laparoscopy, and LTT may offer significant benefits in managing AMI.
- Timely diagnosis and treatment are paramount for reducing mortality in AMI patients.
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