Life-threatening bowel ischaemia can often be treated by balloon angioplasty

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Acute mesenteric ischaemia (AMI) can be successfully treated with endovascular therapy such as balloon angioplasty, according to research from the University of Eastern Finland. The study also found that AMI is a more common cause of abdominal pain among the elderly than generally thought; however, it is difficult to diagnose before bowel damage develops.

In 2009-2013, a total of 66 patients with acute mesenteric ischaemia were treated at Kuopio University Hospital in Finland. Mesenteric revascularisation by endovascular therapy, such as balloon angioplasty or mechanical suction of the blood clot, was attempted in 50 of the patients, proving successful in 44 of the cases. Three of the patients underwent a surgical bypass after failed endovascular therapy. The mortality rate among the 66 patients was only 42%, which is a clear improvement compared to earlier treatment outcomes. Resection of gangrenous bowel was resorted to only in approximately one third of the patients, and more than half of them avoided surgery altogether.

Acute mesenteric ischemia has so far been regarded as a very rare condition. The study analysed the prevalence of the disease within one hospital district in eastern Finland and found that in patients over 75 years of age, AMI is in fact a more common cause of acute abdominal pain than ruptured abdominal aortic aneurysm or acute appendicitis. The mean age of the treated patients was 79 years. Acute mesenteric ischaemia is a disease affecting old people in particular, and underlying risk factors of cardiovascular diseases are typical.

 “We hope that this study will raise awareness among surgeons and radiologists of the prevalence of AMI in older patients, as well as of the diagnostics-related challenges,” says Vascular Surgery and Gastrointestinal Surgery Specialist Jussi Kärkkäinen, who presented the results in his doctoral dissertation.

The findings were originally published in the Journal of Gastrointestinal Surgery, European Journal of Radiology, and CardioVascular and Interventional Radiology.