The Feasibility of a Radiological Score Based on CT Signs for Recognizing Salvageable Bowel in Acute Mesenteric Ischemia (AMESIradiol)

University of Tartu

Status: Enrolling

Conditions: Acute Mesenteric Ischemia

Study type: Observational

Funder types: Other

Identifiers

NCT06445660

03.01.2024

Details and patient eligibility

About

Computed tomography (CT) is the standard modality for scanning patients with critical acute abdominal conditions, including suspected acute mesenteric ischemia (AMI). CT imaging can potentially differentiate between reversible and irreversible ischaemic damage of the bowel. This moment is pivotal in selecting the treatment strategy for AMI - in the absence of irreversible damage; reperfusion therapy can preserve intestinal viability, thereby avoiding the need for bowel resection. The present study tests the hypothesis that combining several symptoms may enhance the diagnostic performance of CT scanning in detecting salvageable bowel in patients with AMI. This study is an ancillary component of the AMESI study (Clinical Trials: NCT05218863) - a prospective, multicentre observational study aimed at identifying the incidence and describing the outcomes of acute mesenteric ischemia (AMI) in adult hospitalized patients. The ultimate purpose of the present study is to create a computed tomography-based radiological score for the assessment of bowel viability in patients with AMI.

Enrollment: 200 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Participant in AMESI study
• confirmed or suspected acute mesenteric ischaemia
• CT scan of the entire abdominal cavity / full body using intravenous contrast media is available

Exclusion criteria

• Scans without the use of an intravenous contrast media or those covering only a partial area of the abdomen will be excluded.

Trial design

200 participants in 3 patient groups

Controls

Description:

Patients included in the AMESI study as suspected AMI

AMI patients with salvageable bowel

Description:

Patients included in the AMESI study with confirmed AMI, who did not undergo bowel resection Patients with one of the following: 1. treated endovascularly and did not undergo bowel resection secondarily 2. received surgical revascularization without bowel resection (initial or secondary) 3. received explorative laparoscopy or laparotomy without the need for bowel resection (initially or secondarily) 4. received conservative treatment without the need for secondary bowel resection

AMI patients with non-salvageable bowel

Description:

Patients included in the AMESI study with confirmed AMI who (one of the following): 1. underwent bowel resection initially 2. underwent bowel resection secondarily 3. did not undergo bowel resection because non-salvageable bowel 4. were changed to palliation due to the progression of ischaemia after any initial treatment with curative intention (including endovascular and conservative)