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Multislice Computed Tomography Angiography in Acute Mesenteric Ischemia

NCT ID: NCT03484442

Last Updated: 2018-03-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

30 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-04-30

Study Completion Date

2019-06-30

Brief Summary

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Acute mesenteric ischemia is a life-threatening condition with high mortality. Acute mesenteric ischemia is responsible for fewer than one in 1000 hospital admissions, but its mortality rate ranges between 30% and 90% . Acute mesenteric ischemia is most commonly secondary to embolism followed by arterial thrombosis, non-occlusive ischemia, and less commonly venous thrombosis . Delay in diagnosis contributes to the continued high mortality rate. Early diagnosis and prompt effective treatment are essential to Correspondence to improve clinical outcomes

Detailed Description

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However, Acute mesenteric ischemia represents a major diagnostic challenge because of its varied presentations and multiple causes . Patients usually present with non-specific abdominal symptoms and laboratory findings, which leads to delayed diagnoses . Therefore, diagnostic imaging has emerged as one of the most crucial components in the diagnostic work-up of suspected

Recent technical advances have made computed tomography angiography the modality of choice in the setting of suspected Acute mesenteric ischemia.computed tomography angiography is a rapid and non-invasive diagnostic tool for assessing intestinal vasculature and bowel . computed tomography angiography allows early diagnosis and differentiation between occlusive and non-occlusive causes, which is important to direct therapeutic approach . Overall, combining vascular and bowel assessment results in a high diagnostic accuracy . A recent meta-analysis showed a sensitivity of 93% and a specificity of 96% . However, this meta analysis also showed that the prevalence of confirmed .Acute mesenteric ischemia is less than 25% among the patients referred to computed tomography angiograph in the setting of suspected Acute mesenteric ischemia .Knowledge of the prevalence and the demographic distribution of alternative diagnoses in the remaining three-fourths of patients without Acute mesenteric ischemia is important for appropriate patient care. computed tomography angiograph is considered to allow for a variety of acute alternative diagnoses, ensuring timely triage of these patients.

Conditions

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Mesenteric Ischemia

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Eligibility Criteria

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Inclusion Criteria

Clinically suspected acute mesenteric ischemia based on physician evaluation Patients should be evaluated during 48 h of acute presentation

Exclusion Criteria

* Renal Impairment
* Known allergy to iodine contrast media.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Basma Fawzy Mohammed

principle investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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Afaf Abdel-Qader Hasan Elmamlok, professor

Role: CONTACT

Phone: 02208843124

Email: [email protected]

Abo-Elhassan Hasseib Mohammed, lecturer

Role: CONTACT

Phone: 02201009562059

Email: [email protected]

References

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Ottinger LW. Mesenteric ischemia. N Engl J Med. 1982 Aug 26;307(9):535-7. doi: 10.1056/NEJM198208263070905. No abstract available.

Reference Type BACKGROUND
PMID: 7048095 (View on PubMed)

Ozden N, Gurses B. Mesenteric ischemia in the elderly. Clin Geriatr Med. 2007 Nov;23(4):871-87, vii-viii. doi: 10.1016/j.cger.2007.07.001.

Reference Type BACKGROUND
PMID: 17923343 (View on PubMed)

Herbert GS, Steele SR. Acute and chronic mesenteric ischemia. Surg Clin North Am. 2007 Oct;87(5):1115-34, ix. doi: 10.1016/j.suc.2007.07.016.

Reference Type BACKGROUND
PMID: 17936478 (View on PubMed)

Paterno F, Longo WE. The etiology and pathogenesis of vascular disorders of the intestine. Radiol Clin North Am. 2008 Sep;46(5):877-85, v. doi: 10.1016/j.rcl.2008.06.005.

Reference Type BACKGROUND
PMID: 19103137 (View on PubMed)

Reginelli A, Iacobellis F, Berritto D, Gagliardi G, Di Grezia G, Rossi M, Fonio P, Grassi R. Mesenteric ischemia: the importance of differential diagnosis for the surgeon. BMC Surg. 2013;13 Suppl 2(Suppl 2):S51. doi: 10.1186/1471-2482-13-S2-S51. Epub 2013 Oct 8.

Reference Type BACKGROUND
PMID: 24267670 (View on PubMed)

Cudnik MT, Darbha S, Jones J, Macedo J, Stockton SW, Hiestand BC. The diagnosis of acute mesenteric ischemia: A systematic review and meta-analysis. Acad Emerg Med. 2013 Nov;20(11):1087-100. doi: 10.1111/acem.12254.

Reference Type BACKGROUND
PMID: 24238311 (View on PubMed)

Martinez JP, Hogan GJ. Mesenteric ischemia. Emerg Med Clin North Am. 2004 Nov;22(4):909-28. doi: 10.1016/j.emc.2004.05.002.

Reference Type BACKGROUND
PMID: 15474776 (View on PubMed)

Sise MJ. Acute mesenteric ischemia. Surg Clin North Am. 2014 Feb;94(1):165-81. doi: 10.1016/j.suc.2013.10.012.

Reference Type BACKGROUND
PMID: 24267504 (View on PubMed)

Ofer A, Abadi S, Nitecki S, Karram T, Kogan I, Leiderman M, Shmulevsky P, Israelit S, Engel A. Multidetector CT angiography in the evaluation of acute mesenteric ischemia. Eur Radiol. 2009 Jan;19(1):24-30. doi: 10.1007/s00330-008-1124-5. Epub 2008 Aug 9.

Reference Type BACKGROUND
PMID: 18690454 (View on PubMed)

Menke J. Diagnostic accuracy of multidetector CT in acute mesenteric ischemia: systematic review and meta-analysis. Radiology. 2010 Jul;256(1):93-101. doi: 10.1148/radiol.10091938.

Reference Type BACKGROUND
PMID: 20574087 (View on PubMed)

Other Identifiers

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CTA

Identifier Type: -

Identifier Source: org_study_id