Multislice Computed Tomography Angiography in Acute Mesenteric Ischemia

Mesenteric Ischemia Clinical Trial

Official title:

Role of Multislice Computed Tomography Angiography In Diagnosis oF Clinically Suspected Acute Mesenteric Ischemia

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT03484442
• Other study ID #: CTA
• Status: Not yet recruiting
• First received: March 24, 2018
• Last updated: March 24, 2018
• Start date: April 2018
• Est. completion date: June 2019

Study information

• Verified date: March 2018
• Source: Assiut University
• Contact: Afaf Abdel-Qader Hasan Elmamlok, professor
• Phone: 02208843124
• Email: afaf.kader[@]aun.edu.eg
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

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

Description:

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.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 30
• Est. completion date: June 2019
• Est. primary completion date: April 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

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.

Related Conditions & MeSH terms

• Ischemia
• Mesenteric Ischemia

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Assiut University

References & Publications (10)

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. Review. — View Citation

Herbert GS, Steele SR. Acute and chronic mesenteric ischemia. Surg Clin North Am. 2007 Oct;87(5):1115-34, ix. Review. — View Citation

Martinez JP, Hogan GJ. Mesenteric ischemia. Emerg Med Clin North Am. 2004 Nov;22(4):909-28. Review. — View Citation

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. Review. — View Citation

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. — View Citation

Ottinger LW. Mesenteric ischemia. N Engl J Med. 1982 Aug 26;307(9):535-7. Review. — View Citation

Ozden N, Gurses B. Mesenteric ischemia in the elderly. Clin Geriatr Med. 2007 Nov;23(4):871-87, vii-viii. Review. — View Citation

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. Review. — View Citation

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:S51. doi: 10.1186/1471-2482-13-S2-S51. Epub 2013 Oct 8. — View Citation

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

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	rate of diagnosis of Acute mesenteric ischemia	number of patients accurately diagnosed acute mesenteric ischemia by multislice computed tomography angiography	48 hours of presentation