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Table 4 Initial management of AMI and its different subtypes

From: Incidence, diagnosis, management and outcome of acute mesenteric ischaemia: a prospective, multicentre observational study (AMESI Study)

 

All

n = 418

Arterial

n = 231

Venous

n = 73

NOMI

n = 55

Othera

n = 11

Unclear

n = 48

Surgical only, n (%)

217 (52.0)

113 (48.7)

31 (42.5)

28 (51.9)

7 (63.6)

38 (79.2)

Laparoscopy

17 (4.1)

6 (2.6)

4 (5.5)

1 (1.8)

1 (9.1)

5 (10.4)

Explorative laparoscopy

10 (2.4)

5 (2.2)

1 (1.4)

1 (1.8)

–

3 (6.3)

Laparoscopic bowel resection

7 (1.7)

1 (0.4)

3 (4.1)

–

1 (9.1)

2 (4.2)

Laparotomy

200 (47.8)

107 (46.3)

27 (37)

 

6 (54.5)

33 (68.8)

Explorative laparotomy

39 (9.3)

19 (8.2)

4 (5.5)

7 (12.7)

–

9 (18.8)

Surgical revascularization

20 (4.8)

19 (8.2)

1 (1.4)

–

–

–

Revascularization and bowel resection

14 (3.3)

12 (5.2)

1 (1.4)

–

1 (9.1)

–

Bowel resection

127 (30.4)

57 (24.7)

21 (28.8)

20 (36.4)

5 (45.5)

24 (50)

Surgical and endovascular, n(%)

25 (6.0)

22 (9.5)

–

1 (1.8)

2 (18.2)

–

Endovascular revascularization with explorative laparotomy

1 (0.2)

1(0.43)

   

–

Endovascular revascularization with bowel resection

7 (1.7)

6 (26)

  

1 (9.1)

–

Hybrid revascularization with explorative laparotomy

6 (1.4)

6 (26)

   

–

Hybrid revascularization with bowel resection

11 (2.6)

9 (3.9)

 

1 (1.8)

1 (9.1)

–

Endovascular, n (%)

54 (12.9)

51 (22.0)

2 (2.7)

–

 

1 (12.1)

Aspiration of thrombus/embolus

18 (4.3)

17 (7.3)

1 (1.4)

–

 

–

Balloon dilatation

10 (2.4)

8 (3.4)

1 (1.4)

–

 

1 (2.1)

Stenting

25 (6.0)

25 (10.8)

–

–

 

–

Thrombolysis

11 (2.6)

11 (4.7)

–

–

 

–

Combined

1 (0.2)

–

1 (1.4)

–

 

–

Interventions in total

      

Revascularization in total, n (%)

113 (27.0)

104 (45.0)

4 (5.5)

1 (1.8)

3 (27.3)

1 (2.1)

Bowel resection without revascularization, n (%)

134 (32.1)

58 (25.1)

24 (32.9)

20 (36.4)

6 (54.5)

26 (54.2)

Bowel resection in total, n (%)

166 (39.7)

85 (36.8)

25 (34.2)

21 (38.2)

9 (81.8)

26 (54.2)

Small bowel resection, n (%)

126 (30.1)

71 (30.7)

23 (31.5)

13 (23.6)

7 (63.6)

12 (25)

Residual small bowel length < 200 cm, n (%)

44 (10.5)

31 (13.4)

3 (4.1)

4 (7.3)

4 (36.4)

2 (4.2)

Large bowel resection, n (%)

84 (20.1)

40 (17.3)

2 (2.7)

17 (30.9)

6 (54.5)

19 (39.6)

Open abdomen, n (%)

90 (21.5)

52 (22.5)

11 (15.1)

14 (25.5)

6 (54.5)

7 (14.6)

Conservative only, n (%)

76 (18.2)

19 (8.2)

39 (53.4)

18 (33.7)

–

–

Full anticoagulation

65 (15.6)

16 (6.9)

38 (52.1)

11 (20.4)

–

–

Prophylactic anticoagulation

4 (1)

1 (0.4)

1 (1.4)

2 (3.7)

–

–

Antiplatelet therapy

17 (4.1)

8 (3.4)

1 (1.4)

8 (14.5)

–

–

End-of-life care, n (%)

46 (11.0)

26 (11.2)

1 (1.4)

8 (14.5)

2 (18.2)

9 (18.8)

  1. NOMI non-occlusive mesenteric ischaemia
  2. aOther included specific mechanisms such as dissection, bowel distortion, mechanical devices for cardiac support and abdominal compartment syndrome
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