Document Detail


A novel approach for percutaneous treatment of massive nonocclusive mesenteric ischemia: tolazoline and glycerol trinitrate as effective local vasodilators.
MedLine Citation:
PMID:  19156878     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Nonocclusive mesenteric ischemia (NOMI) generally affects patients with low cardiac output, resulting in splanchnic hypoperfusion. It includes all forms of mesenteric ischemia without vessel occlusion and makes up between 20 and 30% of all cases of acute mesenteric ischemia. We present the case of a 84-year-old man with a history of total atrioventricular block developing NOMI. This was diagnosed by percutaneous selective catheter arteriography (PSCA), which demonstrated remarkable abrupt termination of the jejunal vasculature and multiple severe spasms of the colonic arteries. Control PSCA after local intraarterial vasodilator therapy (LIVT) with tolazoline and glycerol trinitrate documented an excellent therapeutic result with a completely unremarkable vasculature. Although LIVT was complicated by severe cardiovascular complications inclusive of cardiac arrest with the need of cardiopulmonary resuscitation, the patient fully recovered and was discharged after implantation of a cardiac pacemaker in good clinical condition 7 days later.
Authors:
Christof M Sommer; Boris A Radeleff
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  73     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-01-28     Completed Date:  2009-03-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  152-5     Citation Subset:  IM    
Copyright Information:
(c) 2009 Wiley-Liss, Inc.
Affiliation:
JNF 110, 69120 Heidelberg, Germany. christof.sommer@med.uni-heidelberg.de
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MeSH Terms
Descriptor/Qualifier:
Aged, 80 and over
Cardiopulmonary Resuscitation
Colon / blood supply*
Drug Therapy, Combination
Heart Diseases / complications,  therapy
Humans
Infusions, Intravenous
Injections, Intra-Arterial
Ischemia / complications,  drug therapy*,  radiography
Jejunum / blood supply*
Male
Nitroglycerin / administration & dosage*
Pacemaker, Artificial
Tolazoline / administration & dosage*
Treatment Outcome
Vasodilator Agents / administration & dosage*
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 55-63-0/Nitroglycerin; 59-98-3/Tolazoline

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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