Ann Vasc Surg. 2026 Mar 5:S0890-5096(26)00127-5. doi: 10.1016/j.avsg.2026.02.033. Online ahead of print.
ABSTRACT
OBJECTIVE: This study aimed to retrospectively evaluate the outcomes of endovascular therapy for acute superior mesenteric artery embolism (ASMAE), identify risk factors for intestinal necrosis (IN), and propose a stratified management approach.
METHODS: Clinical data from November 2019 to December 2024 were analyzed. Univariate and binomial logistic regression analyses identified risk factors for IN and developed a predictive model.
RESULTS: The cohort consisted of 54 patients, with 27 in the IN group and 27 in the non-IN group. Compared to the non-IN group, the IN group had significantly higher white blood cell count (WBC) (17.5 × 109/L vs. 12.1 × 109/L, p = 0.001), C-reactive protein (CRP) levels (190 mg/L vs. 17.9 mg/L, p < 0.001), and creatine kinase (CK) (227 U/L vs. 118 U/L, p = 0.033). Multivariate analysis revealed that CRP (β = 0.025, p = 0.006, 95% confidence interval [CI] 1.007-1.043), WBC (β = 0.166, p = 0.044, 95% CI 1.005-1.015), CK (β = 0.008, p = 0.048, 95% CI 1.003-1.015), and rebound tenderness (β = 2.645, p = 0.033, 95% CI 1.238-160.32) as independent risk factors for IN. The resulting predictive model was: Log(P) = -7.922 + CRP × 0.025 + WBC × 0.181 + CK × 0.008 + 2.645 × (0/1). Performance was evaluated via receiver operating characteristic curve analysis.
CONCLUSION: CRP, WBC, CK, and rebound tenderness are independent risk factors for IN in ASMAE. A stratified management approach, including prompt laparoscopic exploration when IN is suspected, is recommended.
PMID:41794126 | DOI:10.1016/j.avsg.2026.02.033