X-RAY ENDOVASCULAR INTERVENTIONS ON THE SUPERIOR MESENTERIC ARTERY IN THE TREATMENT OF PATIENTS WITH ACUTE MESENTERIC CIRCULATORY DISORDERS
Abstract
Introduction. Acute violation of mesenteric circulation occurs as a result of abrupt cessation of blood supply to various parts of the intestine, which, in the absence of diagnosis and timely surgical treatment, leads to cell damage and irreversible changes (necrosis) of the intestine and, generally, death. Early diagnosis and surgical curing, carried out on time, can reduce the high mortality associated with this disease. According to foreign sources, half of the cases of acute mesenteric ischemia are associated with acute embolism of the upper mesenteric artery. Mesenteric emboli may proceed from the left parts of the heart in the presence of atrial fibrillation or in the presence of endocarditis. The purpose of the study. To evaluate the results of X-ray endovascular interventions on the superior mesenteric artery in patients with acute mesenteric circulatory disorders. Materials and methods. The article presents the results of X-ray endovascular interventions on the superior mesenteric artery in 22 patients with acute mesenteric circulatory disorders. Results. Restoration of blood flow was performed in 22 patients with thrombosis and embolism of the superior mesenteric artery in the X-ray room for emergency indications. Methods that were used to restore mesenteric blood circulation : mechanical recanalization of the artery lumen, thrombotic mass extraction, balloon angioplasty and stenting of the occlusion zone. Effective blood flow in the basin of the superior mesenteric artery was achieved in 19 patients. At the same time, blood flow was restored in three patients by repeated X-ray endovascular intervention. Conclusions. The main conditions for successful X-ray endovascular interventions were the early delivery of patients to a multidisciplinary hospital, the performance of multispiral computed tomography (MSCT) in angiography in the conditions of the admission department. Early diagnosis of acute ischemia of mesenteric vessels with the use of urgent X-ray endovascular interventions suggests to reduce postoperative deaths up to 25%.
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