Natkai Safi

• Kazmi, Syed Sajid Hussain; Safi, Natkai; Berge, Simen Tveten; Kazmi, Marryam; Sundhagen, Jon Otto & Julien, Kari [Show all 10 contributors for this article] (2022). Plasma α-Glutathione S-Transferase in Patients with Chronic Mesenteric Ischemia and Median Arcuate Ligament Syndrome. Vascular Health and Risk Management. ISSN 1176-6344. 18, p. 567–574. doi: 10.2147/VHRM.S365625. Full text in Research Archive Show summary

  Background: Chronic mesenteric ischemia (CMI) due to either atherosclerosis of the mesenteric arteries or median arcuate ligament syndrome (MALS) is an underdiagnosed entity. The etiology of MALS and its existence have been debated and questioned. We aimed to identify plasma biomarkers indicating mesenteric ischemia in patients with CMI and MALS. Methods: Plasma α-glutathione S-transferase (α-GST), intestinal fatty acid-binding protein (I-FABP), citrulline, and ischemia modified albumin (IMA) were analyzed in fifty-eight patients with CMI (Group A, n=44) and MALS (Group B, n=14) before and after revascularization. The plasma levels of these potential biomarkers were compared with those of healthy individuals (Group C, n=16). Group comparison was performed with the Mann–Whitney U-test. Cross-tabulation and its derivatives were obtained. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were calculated. Results: Plasma levels of α-GST were significantly raised in the patients with CMI (7.8 ng/mL, p< 0.001) and MALS (8.4 ng/mL, p< 0.001), as compared with the control Group C (3.3 ng/mL). The threshold for normal median plasma α-GST levels of 4 ng/mL yielded a sensitivity of 93% and 86%, specificity of 86% and 88%, respectively, for the diagnosis of CMI due to atherosclerosis and MALS. AUC of ROC curves was 0.96 (p< 0.0001) for CMI and 0.85 (p< 0.002) for MALS. The patient groups did not differ from the healthy controls in any other biomarkers. Conclusion: Plasma α-GST levels are elevated in CMI and MALS patients. Elevated plasma levels of α-GST suggest ischemia as the etiology of MALS.

• Safi, Natkai; Ånonsen, Kim Vidar; Berge, Simen Tveten; Medhus, Asle Wilhelm; Sundhagen, Jon Otto & Hisdal, Jonny [Show all 7 contributors for this article] (2022). Early Identification of Chronic Mesenteric Ischemia with Endoscopic Duplex Ultrasound. Vascular Health and Risk Management. ISSN 1176-6344. p. 233–243. doi: 10.2147/VHRM.S358570. Full text in Research Archive
• Kazmi, Syed Sajid Hussain; Safi, Natkai; Berge, Simen Tveten; Kazmi, Marryam; Sundhagen, Jon Otto & Hisdal, Jonny (2022). Laparoscopic Surgery for Median Arcuate Ligament Syndrome (MALS): A Prospective Cohort of 52 Patients. Vascular Health and Risk Management. ISSN 1176-6344. 18, p. 139–151. doi: 10.2147/VHRM.S350841. Full text in Research Archive Show summary

  Background: The selection of patients with MALS for surgical treatment depends upon the reliability of the symptom interpretation and the diagnostic work-up. We aimed to follow up the results of the laparoscopic decompression of the patients with MALS. Patients and Methods: In a single-center, 52 consecutive MALS patients were followed-up, prospectively, after transperitoneal laparoscopic decompression. MALS was diagnosed with a computed tomography angiography (CTA) verified stenosis, ≥ 50% of the celiac artery (CA), and with duplex ultrasound, a peak systolic velocity (PSV) ≥ 2.0 m/s. Postoperative, CTA, and duplex ultrasound were performed, and the patients were followed-up at 3, 6, 12 months, and yearly after that. Results: Mean age of the patients was 47 ± 21 years, and 65% were females. The patients had a mean weight loss of 8.4 ± 7.2 kg. Fifty-one patients had the laparoscopic operation with a mean operation time of 102 ± 28 minutes. Forty-seven patients (90%) achieved relief from the symptoms either completely (67%) or partially (23%) at 3– 6 months of follow-up. Significant improvement in postoperative PSV was found compared to the preoperative values, p< 0.001. Five patients (10%) with no immediate effect of the operation, but two of them became free from symptoms during the mean study follow-up of 2.4 ± 2 years. Five patients (10%) had operative complications, including one trocar injury to the liver, one pneumothorax, and three cases of bleeding from the branches of CA. Two patients died of cancer disease during the study period. Only two patients (4%) had symptoms relapse, both later treated successfully. Conclusion: Laparoscopic transperitoneal decompression provides most of the patients a persistent relief from MALS symptoms. Keywords: median arcuate ligament syndrome, postprandial pain, laparoscopy, mesenteric ischemia

• Safi, Nathkai; Johannessen, Hans Olaf; Medhus, Asle Wilhelm; Mala, Tom & Kazmi, Syed Sajid Hussain (2020). Laser doppler flowmetry and visible light spectroscopy of the gastric tube during minimally invasive esophagectomy. Vascular Health and Risk Management. ISSN 1176-6344. 16, p. 497–505. doi: 10.2147/VHRM.S269138. Full text in Research Archive
• Berge, Simen Tveten; Safi, Nathkai; Medhus, Asle Wilhelm; Sundhagen, Jon Otto; Hisdal, Jonny & Kazmi, Syed Sajid Hussain (2020). Perioperative microcirculatory changes detected with gastroscopy assisted laser doppler flowmetry and visible light spectroscopy in patients with median arcuate ligament syndrome. Vascular Health and Risk Management. ISSN 1176-6344. 16, p. 331–341. doi: 10.2147/VHRM.S252192. Full text in Research Archive
• Berge, Simen Tveten; Safi, Nathkai; Medhus, Asle Wilhelm; Ånonsen, Kim Vidar; Sundhagen, Jon Otto & Hisdal, Jonny [Show all 7 contributors for this article] (2019). Gastroscopy assisted laser Doppler flowmetry and visible light spectroscopy in patients with chronic mesenteric ischemia. Scandinavian Journal of Clinical and Laboratory Investigation. ISSN 0036-5513. 79(7), p. 541–549. doi: 10.1080/00365513.2019.1672084. Full text in Research Archive

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