PURPOSE: Retrospective evaluation of 12-year experience with endovascular management of acute mesenteric ischemia (AMI) due to embolic occlusion of the superior mesenteric artery (SMA). MATERIALS AND 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 %. CONCLUSION: 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 %.

• MeSH
• akutní nemoc MeSH
• arteria mesenterica superior * MeSH
• endovaskulární výkony metody   mortalita   MeSH
• lidé MeSH
• mezenteriální cévní okluze mortalita   chirurgie   MeSH
• mortalita v nemocnicích MeSH
• retrospektivní studie MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: To evaluate the influence of endovascular therapy of ruptured abdominal or iliac aneurysms on total mortality. MATERIALS AND METHODS: We analyzed the mortality of 40 patients from 2005 to 2009, when only surgical treatment was available. These results were compared with the period 2010 to 2013, when endovascular aneurysm repair (EVAR) was assessed as the first option in selected patients. RESULTS: During 2005 to 2009, the mortality was 37.5%. From 2010 to 2013, 45 patients were treated with mortality 28.9%. Open repair was performed in 35 (77.8%) patients and EVAR in 10 (22.2%) patients. The 30-day and 1-year mortality rates of the EVAR group were 0% and 20%, respectively, and the total mortality rate was 30% during follow-up (median 11 months, range 1-42 months). The 30-day mortality in the surgical group remained unchanged, at 37.1%, and 1-year and total mortality rates were 45.7% and 51.4%, respectively. CONCLUSION: Following integration in the treatment algorithm, EVAR decreased total mortality in our center by 8.6%.

• MeSH
• algoritmy * MeSH
• aneurysma břišní aorty diagnóza   mortalita   chirurgie   MeSH
• aneurysma ilické tepny diagnóza   mortalita   chirurgie   MeSH
• aortografie metody   MeSH
• časové faktory MeSH
• cévní protézy MeSH
• cévy - implantace protéz * škodlivé účinky   přístrojové vybavení   mortalita   MeSH
• endovaskulární výkony * škodlivé účinky   přístrojové vybavení   mortalita   MeSH
• integrované poskytování zdravotní péče * MeSH
• kritické cesty MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemocnice univerzitní * MeSH
• počítačová rentgenová tomografie MeSH
• prasklé aneurysma diagnóza   mortalita   chirurgie   MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• ruptura aorty diagnóza   mortalita   chirurgie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• stenty MeSH
• studie proveditelnosti MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH
• srovnávací studie MeSH
• Geografické názvy
• Česká republika MeSH