Table. Endovascular treatment for AMI.
Treatment | Indication | Level of evidence |
Arterial | ||
Transfemoral aspiration embolectomy | Large embolus close to outlet | IIa, C |
IA continuous drug perfusion (papaverine, prostavasin, heparin) | Peripheral embolism with no peritonitis | IIa, C |
nonocclusive ischemia | ||
Local fibrinolysis (rt-PA) | Peripheral embolism with no peritonitis | IIa, C |
as diagnostic technique for cases of stenosis | ||
Stent PTA | Stenoses and occlusions close to outlet | I, B |
Portal venous (transjugular transhepatic) | ||
Portal venous rechanneling | Ischemia of the wall of the intestine in cases of mesenteric/portal venous thrombosis | IV |
Portal decompression (TIPS) | Portal hypertension with venous ischemia of the wall of the intestine caused by congestion | IV |
AMI: acute mesenteric ischemia; IA: intraarterial; rt-PA: recombinant tissue plasminogen activator; PTA: percutaneous transluminal angioplasty; TIPS, transjugular intrahepatic portosystemic stent shunt