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Writing Committee, M. Björck, M. Koelemay, S. Acosta, F

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Presentation on theme: "Writing Committee, M. Björck, M. Koelemay, S. Acosta, F"— Presentation transcript:

1 Editor's Choice – Management of the Diseases of Mesenteric Arteries and Veins
Writing Committee, M. Björck, M. Koelemay, S. Acosta, F. Bastos Goncalves, T. Kölbel, J.J. Kolkman, T. Lees, J.H. Lefevre, G. Menyhei, G. Oderich, ESVS Guidelines Committee, P. Kolh, G.J. de Borst, N. Chakfe, S. Debus, R. Hinchliffe, S. Kakkos, I. Koncar, J. Sanddal Lindholt, M. Vega de Ceniga, F. Vermassen, F. Verzini, Document Reviewers, B. Geelkerken, P. Gloviczki, T. Huber, R. Naylor European Journal of Vascular and Endovascular Surgery Volume 53, Issue 4, Pages (April 2017) DOI: /j.ejvs Copyright © 2017 European Society for Vascular Surgery Terms and Conditions

2 Figure 1 Collateral arcades between the main mesenteric arterial trunks: the pancreaticoduodenal arcades described by Rio Branco and Bühler between the superior mesenteric artery and the coeliac trunk; the Riolan, Villemin, and Drummond arcades between the inferior and superior mesenteric arteries. The mesenteric artery ends with the superior rectal arteries which originate from the internal iliac arteries via the middle rectal arteries. European Journal of Vascular and Endovascular Surgery , DOI: ( /j.ejvs ) Copyright © 2017 European Society for Vascular Surgery Terms and Conditions

3 Figure 2 Patient with an acute embolic occlusion of the SMA. CTA images in transverse (A), coronal (B), and sagittal (C) projection. The typical oval-shaped embolic occlusion is best seen in the sagittal projection (C). SMA angiography prior to (D) and after (E) local administration of 18 mg of alteplase with clearance of embolus. Laparoscopy was negative, and recovery was uneventful. European Journal of Vascular and Endovascular Surgery , DOI: ( /j.ejvs ) Copyright © 2017 European Society for Vascular Surgery Terms and Conditions

4 Figure 3 Meta-analysis of bowel resection rates after open and endovascular therapy of AMI. European Journal of Vascular and Endovascular Surgery , DOI: ( /j.ejvs ) Copyright © 2017 European Society for Vascular Surgery Terms and Conditions

5 Figure 4 Meta-analysis of 30-day mortality rates after open and endovascular therapy of AMI. European Journal of Vascular and Endovascular Surgery , DOI: ( /j.ejvs ) Copyright © 2017 European Society for Vascular Surgery Terms and Conditions

6 Figure 5 Meta-analysis of mortality after open and endovascular revascularisation. (This meta-analysis was performed by the GWC in March 2016, and is only published in this document.) European Journal of Vascular and Endovascular Surgery , DOI: ( /j.ejvs ) Copyright © 2017 European Society for Vascular Surgery Terms and Conditions

7 Figure 6 Flow diagram of suggested management of MVT. This flow diagram was developed by the GWC. CTA = computed tomography angiography; TIPS = transjugular intrahepatic portosystemic shunt; MVT = mesenteric venous thrombosis. European Journal of Vascular and Endovascular Surgery , DOI: ( /j.ejvs ) Copyright © 2017 European Society for Vascular Surgery Terms and Conditions

8 Figure 7 A patient with MVT and bowel ischaemia. CTA of the abdomen showing extensive thrombosis of the superior mesenteric, splenic, extra- and intra-hepatic portal venous system (on the left). Partial recanalisation (extra-hepatic portal vein and a few branches of the superior mesenteric vein) using an endovascular procedure (on the right). European Journal of Vascular and Endovascular Surgery , DOI: ( /j.ejvs ) Copyright © 2017 European Society for Vascular Surgery Terms and Conditions