Revascularization of acute XXXX after creation of a dedicated multidisciplinary center.

@entity1 @entity64 @entity341 @entity5277 @entity5327
OBJECTIVE: Arterial acute @entity5327 (AAMI) is a vascular and @entity341 , most often surgical, still associated with a poor prognosis and frequent @entity5277 in survivors. We report the results of revascularization in AAMI @entity1 after the creation of an intestinal @entity64 center. METHODS: Since July 2009, we developed a multimodal and multidisciplinary management for AMI, focusing on intestinal viability and involving gastroenterologists, vascular and abdominal surgeons, radiologists, and intensive care specialists. This management was the first step to the creation of an intestinal @entity64 center, based on the @entity64 unit model. All @entity1 received: (1) a specific medical protocol; (2) endovascular and/or open surgical revascularization whenever possible; and/or (3) resection of non-viable small bowel. We aimed to study survival, morbidity, type of revascularization, and bowel resection in @entity1 who benefited from arterial revascularization in our intestinal @entity64 center. RESULTS: Eighty-three @entity1 with AMI were prospectively enrolled in the intestinal @entity64 center. Among them, 29 @entity1 with AAMI underwent revascularization. The mean age was 50.2     12  years, with 41% of male gender. The mean follow-up was 22.7     19  months. Overall 2-year survival was 89.2%, and 30-day operative mortality was 6.9%. Surgical revascularization included bypass grafting (65%), endarterectomy with patch angioplasty (21%)     retrograde open mesenteric stenting of the superior mesenteric artery (7%), and endovascular revascularization as first stage procedure (38%). The 2-year primary patency rate of open revascularization was 88%. The rate and the median length of bowel resected were 24% and 43  cm (range, 36-49  cm), respectively. CONCLUSIONS: In our experience, revascularization of AAMI @entity1 as part of a multidisciplinary and multimodal management leads to encouraging results. Vascular surgeons have a central role in a dedicated intestinal @entity64 center.
