Introduction:

acute mesenteric ischemia (AMI) due to occlusion of the superior mesenteric artery is an infrequent pathology, with high mortality and without standardized management.

Objective:

analyze the results in our center after the creation of our own multidisciplinary therapeutic algorithm with the involvement of the Vascular Surgery team

Methods:

retrospective single-center study of all the cases of AMI treated between 2017-2022, where all treatments were agreed by a multidisciplinary team that includes Vascular Surgery, General Surgery and Angioradiology. Delay times (until diagnosis and intervention), mesenteric revascularization procedure, adjuvant procedures performed, the need for vascular reintervention as well as in-hospital mortality were analyzed.

Results:

18 cases of AMI were registered (13 of embolic etiology and 5 thrombotic). In all cases, a revascularization procedure was performed, mostly (78 %) embolectomies. 61 % required associated intestinal resection (median, 123 cm; IQR, 66 cm). Despite effective revascularization in most cases (only 17 % required reintervention), hospital’s mortality rate was 61 %, with longer delays to diagnosis in the deceased (9.6 hours vs. 4.3 hours, p = 0.221) and treatment (6.3 hours vs. 4.2 hours, p = 0.298).

Conclusions:

the use of a specific therapeutic algorithm for AMI has achieved good rates of effective revascularization, although a high mortality rate persists, probably related to the diagnostic and therapeutic delay.

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