title: Endovascular Management of Acute Embolic Occlusion of the Superior Mesenteric Artery: A 12-Year Single-Centre Experience.
abstract: OBJECTIVE
  Retrospective evaluation of 12-year experience with endovascular management of acute mesenteric ischemia (AMI) due to embolic occlusion of the superior mesenteric artery (SMA).
  
  
  METHODS
  From 2003 to 2014, we analysed the in-hospital mortality of 37 patients with acute mesenteric embolism who underwent primary endovascular therapy with subsequent on-demand laparotomy. Transcatheter embolus aspiration was used in all 37 patients (19 women, 18 men, median age 76 years) with embolic occlusion of the SMA. Adjunctive local thrombolysis (n = 2) and stenting (n = 2) were also utilised.
  
  
  RESULTS
  We achieved complete recanalization of the SMA stem in 91.9 %. One patient was successfully treated by surgical embolectomy due to a failed endovascular approach. Subsequent exploratory laparotomy was performed in 73.0 % (n = 27), and necrotic bowel resection in 40.5 %. The total in-hospital mortality was 27.0 %.
  
  
  CONCLUSIONS
  Primary endovascular therapy for acute embolic SMA occlusion with on-demand laparotomy is a recommended algorithm used in our centre to treat SMA occlusion. This combined approach for the treatment of AMI is associated with in-hospital mortality rate of 27.0 %.
authors.affiliation: Department of Radiology, Faculty of Medicine at Charles University and University Hospital, Sokolska Street, Hradec Kralove, Czech Republic. janraupach@seznam.cz.
authors.forename: J
authors.initials: J
authors.lastname: Raupach
authors.affiliation: Department of Radiology, Faculty of Medicine at Charles University and University Hospital, Sokolska Street, Hradec Kralove, Czech Republic. miroslav.lojik@fnhk.cz.
authors.forename: M
authors.initials: M
authors.lastname: Lojik
authors.affiliation: Department of Radiology, Faculty of Medicine at Charles University and University Hospital, Sokolska Street, Hradec Kralove, Czech Republic. chovanec.v@seznam.cz.
authors.forename: V
authors.initials: V
authors.lastname: Chovanec
authors.affiliation: Department of Radiology, Faculty of Medicine at Charles University and University Hospital, Sokolska Street, Hradec Kralove, Czech Republic. ondrejrenc@seznam.cz.
authors.forename: O
authors.initials: O
authors.lastname: Renc
authors.affiliation: Faculty of Medicine at Charles University, Hradec Kralove, Czech Republic. m.strycek@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Strýček
authors.affiliation: Department of Radiology, Faculty of Medicine at Charles University and University Hospital, Sokolska Street, Hradec Kralove, Czech Republic. petr.dvorak@fnhk.cz.
authors.forename: P
authors.initials: P
authors.lastname: Dvořák
authors.affiliation: Department of Radiology, Faculty of Medicine at Charles University and University Hospital, Sokolska Street, Hradec Kralove, Czech Republic. hoffmpet@fnhk.cz.
authors.forename: P
authors.initials: P
authors.lastname: Hoffmann
authors.affiliation: Department of Surgery, Faculty of Medicine at Charles University and University Hospital, Hradec Kralove, Czech Republic. gunka@email.cz.
authors.forename: I
authors.initials: I
authors.lastname: Guňka
authors.affiliation: Department of Surgery, Faculty of Medicine at Charles University and University Hospital, Hradec Kralove, Czech Republic. a.ferko@seznam.cz.
authors.forename: A
authors.initials: A
authors.lastname: Ferko
authors.affiliation: Department of Radiology, Faculty of Medicine at Charles University and University Hospital, Sokolska Street, Hradec Kralove, Czech Republic. ryska@fnhk.cz.
authors.forename: P
authors.initials: P
authors.lastname: Ryška
authors.affiliation: Department of Cardiac Surgery, Faculty of Medicine at Charles University and University Hospital, Hradec Kralove, Czech Republic. nidal81@gmail.com.
authors.forename: N
authors.initials: N
authors.lastname: Omran
authors.affiliation: Department of Radiology, Faculty of Medicine at Charles University and University Hospital, Sokolska Street, Hradec Kralove, Czech Republic. krajina@fnhk.cz.
authors.forename: A
authors.initials: A
authors.lastname: Krajina
authors.affiliation: Department of Radiology, Faculty of Medicine at Charles University and University Hospital, Sokolska Street, Hradec Kralove, Czech Republic. pavla.cabelkova@fnhk.cz.
authors.forename: P
authors.initials: P
authors.lastname: Čabelková
authors.affiliation: Computer Technology Center, Faculty of Medicine at Charles University, Hradec Kralove, Czech Republic. cermakovae@lfhk.cuni.cz.
authors.forename: E
authors.initials: E
authors.lastname: Čermáková
authors.affiliation: Department of Medicine, Faculty of Medicine at Charles University and University Hospital, Hradec Kralove, Czech Republic. malyr@volny.cz.
authors.forename: R
authors.initials: R
authors.lastname: Malý
mesh_terms: D000208:Acute Disease; D000368:Aged; D057510:Endovascular Procedures / Q000379:methods* / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior; D008641:Mesenteric Vascular Occlusion / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Acute intestinal ischemia; Aspiration; Endovascular repair; Mesenteric artery stenting; Superior mesenteric artery occlusion