Mesenteric ischemia secondary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Feham Tariq, MD [2]

Overview

Effective measures to prevent recurrence of mesenteric ischemia include screening by duplex ultrasonography, nutritional and life style modification, and drug therapy.

Secondary Prevention

The secondary prevention of mesenteric ischemia is similar to its primary prevention.

Effective measures for the secondary prevention of mesenteric ischemia includes the following:[1][2][3][4]

  • In patients with history of mesenteric ischemia, duplex ultrasonography is recommended after every 6 months for one year, and yearly thereafter.
  • All patients at risk of developing mesenteric ischemia, should be educated about the signs and symptoms of the disease.
  • Patients who undergo endovascular repair for mesenteric ischemia should be recommended the following:
    • Lifelong aspirin and statin therapy
    • Clopidogrel for 1-3 months after the procedure
    • Lifelong oral anticoagulants in case of persistent atrial fibrillation, mesenetric venous thrombosis and inherited or acquired thrombophilias.
    • Nutritional status and body weight should be monitored

References

  1. Klempnauer J, Grothues F, Bektas H, Pichlmayr R (1997). "Long-term results after surgery for acute mesenteric ischemia". Surgery. 121 (3): 239–43. PMID 9068664.
  2. Otte JA, Geelkerken RH, Huisman AB, Kolkman JJ (2007). "What is the best diagnostic approach for chronic gastrointestinal ischemia?". Am J Gastroenterol. 102 (9): 2005–10. doi:10.1111/j.1572-0241.2007.01359.x. PMID 17573786.
  3. Veenstra RP, ter Steege RW, Geelkerken RH, Huisman AB, Kolkman JJ (2012). "The cardiovascular risk profile of atherosclerotic gastrointestinal ischemia is different from other vascular beds". Am J Med. 125 (4): 394–8. doi:10.1016/j.amjmed.2011.09.013. PMID 22305578.
  4. Tokgözoğlu L, Bariş Kaya E (2008). "Atherosclerotic vascular disease and risk factors in Turkey: from past to present". J Atheroscler Thromb. 15 (6): 286–91. PMID 19075493.

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