Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic mesenteric ischemia is often a disabling condition associated with intestinal angina, weight loss, and sitophobia (a morbid aversion of food). Significant stenosis of two of the three main arteries of the gut is usually required to produce symptoms. Surgical therapy has included reimplantation and bypass grafting, usually with synthetic conduits and occasionally endarterectomy. Newer techniques have made endovascular treatment an emerging modality in managing some of the difficult lesions in the mesenteric circulation that cause chronic mesenteric ischemia. We describe the first reported case of blunt microdissection using a Frontrunner XP(R) CTO Catheter (Lumend, Redwood City, CA) to successfully cross, subsequently wire and stent a four-year-old chronic total occlusions in a celiac trunk, which also gave origin to the superior mesenteric artery.
 ...
PMID:Successful use of blunt microdissection catheter in a chronic total occlusion of a celiomesenteric artery. 1732 62

Clinical manifestations of chronic mesenteric ischemia (CMI) can range from vague abdominal pain to debilitating states of intestinal angina resulting in significant weight loss and morbidity. Once the condition has been diagnosed, treatment usually is elective, except in rare cases of rapid progression to acute mesenteric ischemia. Medical management of CMI is mostly supportive. However, in disorders of coagulation, antiplatelet agents and warfarin may be helpful to prevent further thrombosis, and these disorders may require lifelong therapy. For decades, the mainstay of therapy for CMI has been surgery. Extensive disease often requires complete revascularization, although bypass of the superior mesenteric artery alone also has been shown to be effective. Multiple variations of surgical bypass have been advocated but require further evaluation to determine efficacy. Transaortic endarterectomy is a viable option for limited disease. Minimally invasive vascular procedures such as percutaneous endovascular angioplasty and stenting are proving to be effective for short-segment atherosclerotic stenosis, particularly near the origin of the vessels. Although endovascular therapy has less long-term durability compared with open surgical procedures, these treatments prove simpler, with shortened hospital stays and reduced morbidity. Furthermore, angiographic therapy is a feasible alternative for patients in whom surgery is deemed precarious.
 ...
PMID:Chronic mesenteric ischemia. 1729 59

Abdominal angina followed by an active vascular intervention constitutes an infrequent sequence of events. The limited experience in the active management of this, potentially lethal, condition prompted us to present the case of a 54 year old man with an exceedingly rare etiology of mesenteric ischemia. The underlying cause was kinking of the superior mesenteric artery in combination with ostial stenosis of the celiac trunk. The initial management strategy included an interventional radiological procedure because patient initially declined the surgical treatment. The second intervention was a surgical revascularization of the diseased segment of the abdominal vasculature. The surgical treatment led to complete resolution of his symptoms.
 ...
PMID:Abdominal angina caused by kinking of the superior mesenteric artery. 1914 40

Abdominal angina is an underrecognized cause of postprandial abdominal pain and weight loss. Diagnosis is often delayed and requires both a careful exclusion of more common causes and a high degree of clinical suspicion, based on the patient's age, the coexistence of multiple risk factors for atherosclerosis, and the presence of vasculopathy in other districts. Appropriate investigations include duplex ultrasound, traditional angiography, magnetic resonance angiography, computed tomography angiography, and tonometry. The purpose of this review is to discuss the pathophysiology and clinical presentation of chronic mesenteric ischemia and to suggest a diagnostic flowchart for this complex condition.
 ...
PMID:Abdominal angina. 1979 3

Mesenteric ischemia is classified as either acute or chronic. The former is a life-threatening emergency in which a sudden reduction in intestinal blood flow may ultimately result in bowel infarction. The most common causes are arterial embolism, arterial thrombosis, nonocclusive mesenteric ischemia, and mesenteric venous thrombosis. A high index of suspicion, early diagnosis and rapid intervention are necessary so that normal mesenteric perfusion is restored before fatal bowel infarction can occur. Chronic mesenteric ischemia is usually caused by stenotic or occlusive disease involving the proximal segments of the mesenteric arterial supply to the bowel, usually as a result of atherosclerosis. Intestinal angina is the classic presentation, defined as recurrent postprandial abdominal pain that subsides in 1 to 2 hours, with associated weight loss and aversion to food. When combined with the clinical presentation, physical examination, and laboratory data, imaging plays a key role in the diagnosis of either acute or chronic mesenteric ischemia. Recognition of pertinent imaging findings and various treatment options may aid in preventing the serious and possibly fatal sequelae that may occur in cases of mesenteric ischemia.
 ...
PMID:Mesenteric ischemia. 2132 62

Ischemic bowel disease results from an acute or chronic drop in the blood supply to the bowel and may have various clinical presentations, such as intestinal angina, ischemic colitis or intestinal infarction. Elderly patients with systemic atherosclerosis who are symptomatic for the disease in two or more vascular beds have multiple comorbidities and are particularly at risk. The clinical evolution and outcome of this disease are difficult to predict because of its pleomorphic aspects and the general lack of statistical data. In this paper, we present the case of a patient who was monitored in our unit for six years. For this patient, we encountered iterative changes in the clinical pattern, beginning with chronic "intestinal angina" and finishing with signs of acute mesenteric ischemia after an episode of ischemic colitis. This evolution is particularly rare in clinical practice, and the case is instructive because it raises discussions about the natural history of the condition and the therapeutic decisions that should be made at every stage of the disease. An important lesson is that ischemic bowel disease should always be considered in patients who have multiple risk factors for atherosclerosis and have experienced recurrent "indistinct" abdominal symptoms. In these cases, aggressive investigation and therapeutic decisions must be taken whenever possible. Despite an absence of standardized protocols, angiographic evaluation and revascularization procedures have beneficial outcomes. Current advances in endovascular therapy, such as percutaneous transluminal angioplasty with stenting, should be increasingly used in patients with chronic mesenteric ischemia. Such therapy can avoid the risks that are associated with open repair. However, technical difficulties, especially in severe stenotic lesions, frequently occur.
 ...
PMID:Ischemic colitis and large bowel infarction: a case report. 2311 60


<< Previous 1 2 3