role of endovascular therapy in patients with acute occlusive mesenteric ischemia?
The primary goal of any treatment is revascularization of the affected bowel to restore normal function and prevent infarction. Open surgery has traditionally been the standard of care.
Endovascular techniques including aspiration embolectomy, thrombolysis, and stenting have been successfully described in the literature to treat acute occlusive mesenteric ischemia but most are case reports and small series.
If there are no indications of bowel infarction (peritoneal symptoms, pneumoperitoneum, or intramural air on CT), then endovascular treatment may be considered but this should be a multidisciplinary decision based on local expertise with involvement of a vascular surgeon, interventional radiologist, and intensivist.