title: Debate: Whether an endovascular-first strategy is the optimal approach for treating acute mesenteric ischemia.
abstract: Acute mesenteric ischemia continues to be a life-threatening insult in often-elderly patients with many comorbidities. Recognition and correct diagnosis can be an issue leading to delays in therapy that result in loss of bowel or life, or both. The basic surgical principals in treating acute mesenteric ischemia have long been early recognition, resuscitation, urgent revascularization, resection of necrotic bowel, and reassessment with second-look laparotomies. Endovascular techniques now offer a less invasive alternative, but whether an endovascular-first or open surgery-first approach is preferred in most patients is unclear. Our discussants will attempt to clarify these issues.
authors: Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden. Electronic address: martin.bjorck@surgsci.uu.se.
authors: Martin
authors: M
authors: Björck
authors: Department of Surgery, University of Kentucky, Lexington, Ky.
authors: Nathan
authors: N
authors: Orr
authors: Department of Surgery, University of Kentucky, Lexington, Ky. Electronic address: edende0@uky.edu.
authors: Eric D
authors: ED
authors: Endean
mesh_terms: D000208:Acute Disease; D042241:Early Diagnosis; D057510:Endovascular Procedures / Q000009:adverse effects; D006801:Humans; D065666:Mesenteric Ischemia / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D018579:Patient Selection; D018570:Risk Assessment; D012307:Risk Factors; D013152:Splanchnic Circulation; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects