A Case of Acute Superior Mesenteric Artery Occlusion Treated by Intraarterial Infusion of Urokinase and Prostaglandin E1

Miyazawa, Tomonori; Ueki, Kazunori; Wakakuwa, Ryuji

doi:10.3919/jjsa.65.3293

Cited by 6 publications

(5 citation statements)

References 1 publication

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“…Although thrombolytic provides a good result in early period, it is not recommended because of the risk of bleeding after developing intestinal necrosis. 15,16 Catheter-directed thrombolysis may cause necrosis due to prolonged duration. Even partial successful revascularization may be sufficient in mesenteric interventions because collateral circulation between celiac truncus, inferior mesenteric artery, drummond artery, marginal artery, distal arcade collaterals provides adequate perfusions of distal vascular segments.…”

Section: Discussionmentioning

confidence: 99%

In-Hospital and Short-Term Outcomes of Endovascular Treatment in Patients With Acute Thromboembolic Occlusion of the Superi̇or Mesenteri̇c Artery

et al. 2021

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Objectives: To investigate the outcome of endovascular treatment in acute thromboembolic occlusion of the superior mesenteric artery. Methodology: Eighteen consecutive patients who underwent endovascular treatment in acute thromboembolic occlusion of the superior mesenteric artery from January 2013 to September 2019 were included in the study. Thirty-day mortality, avoidance of laparotomy, angiographic success, length of hospital stay and complication rates were assessed. Results: The patients were 46 to 87 (70.5 ± 13.0) year-old, and 9 (50%) were male. In our study, 30-day mortality rate was 33.3%. The remaining patients were discharged uneventfully. Our complete and partial success rates was 61.1% and 38.9% respectively on angiographic assessment. The mean length of hospital stay was 7.8 ± 5.0 days in the remaining patients. Short bowel syndrome, respiratory failure requiring mechanical ventilation support or renal failure requiring dialysis were not observed in remaining patients. Laparotomy was needed for eight patients after endovascular treatment. Conclusion: The data showed that endovascular treatment is a technically feasible, effective and reliable alternative treatment method in a selected group of patients with acute thromboembolic occlusion of the superior mesenteric artery.

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Section: Discussionmentioning

confidence: 99%

In-Hospital and Short-Term Outcomes of Endovascular Treatment in Patients With Acute Thromboembolic Occlusion of the Superi̇or Mesenteri̇c Artery

et al. 2021

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“…A less well-established approach is the local infusion of thrombolytic therapy or a percutaneous aspiration thrombectomy with or without balloon dilation, both of which have proven to be successful. [8][9][10] Thrombolytic therapy has resulted in good outcomes during the early stages of SMA occlusion, although this therapy is not recommended after intestinal necrosis has developed, [11] causing an increased hemorrhage risk. [12] There are several techniques which require the infusion of a thrombolytic agent, with the most common being the McNamara protocol for peripheral arterial or graft occlusions, which involves a high-dose infusion.…”

Section: Discussionmentioning

confidence: 99%

Successful recanalization of a superior mesenteric artery thrombotic occlusion via a percutaneous rotational thrombectomy

Dumantepe¹

2015

Turk Gogus Kalp Dama

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Akut mezenterik iskemi, bağırsak kan akımının ani kesilmesine bağlı, sıklıkla bağırsak enfarktüsüne yol açan ciddi bir abdominal acilidir. Bağırsakta yaygın, geri dönüşsüz kangren gelişmeden önce süperior mezenterik arter (SMA) embolisinin erken tanı ve tedavisi önemlidir. Altmış üç yaşında bir erkek hasta hastanemiz acil servisine ani başlangıçlı ve gittikçe kötüleşen karın ağrısı şikayeti ile başvurdu. Hastaya acil olarak uygulanan kontrastlı bilgisayarlı tomografide SMA'da emboli gözlendi. İntestinal nekroz bulgusu olmadığından, derhal rotasyonel trombektomiye başlandı. Trombüs aspirasyonu 6 French gauge Aspirex ® S kateteri kullanılarak uygulandı. Mezenterik akımın reperfüzyonu 20 dakika içerisinde sağlandı. İşlemden dokuz ay sonra, Doppler ultrasonda SMA'nın patent olduğu gözlendi. İleri bağırsak iskemisi bulguları olmayan seçilmiş hastalarda akut SMA tıkanıklığı için Aspirex ® S kateteri ile perkütan revaskülarizasyon, cerrahiye karşı hızlı, güvenilir ve umut verici bir alternatif olabilir. Anah tar söz cük ler: Aspirasyon trombektomisi; bağırsak iskemisi; süperior mezenterik arter tıkanıklığı.

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“…Surgery, such as SMA embolectomy, SMA bypass, and resection of necrotic bowel, has been attempted, but the mortality rates have been reported ranging from 35 to 100% [ 7 , 8 ]. Thrombolytic therapy has resulted in good outcomes during the early stages of the disease, although this therapy is not recommended after intestinal necrosis has developed [ 4 ] and hemorrhage risk is increased [ 2 - 6 ]. There are several techniques for infusion of the thrombolytic agent; the more commonly used is the McNamara protocol for peripheral arterial or graft occlusions, which involves a high-dose infusion [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Successful aspiration and thrombolytic therapy for acute superior mesenteric artery occlusion

Byun

2012

J Korean Surg Soc

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To report a case of acute superior mesenteric artery (SMA) embolism successfully treated with aspiration and pharmacological thrombolysis. A 74-year-old female was admitted to the hospital with acute abdominal pain 5 hours in duration. Computed tomography angiography revealed a complete embolic occlusion distal to the first jejunal branch of the SMA. Aspiration and local continuous thrombolysis with urokinase resulted in near complete revascularization of the mesenteric flow after 4 hours and almost complete restoration after 20 hours. The patient made a complete recovery and continues to do well on warfarin therapy after treatment. Aspiration and thrombolytic therapy can be an alternative treatment modality in surgical high risk patient.

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A Case of Acute Superior Mesenteric Artery Occlusion Treated by Intraarterial Infusion of Urokinase and Prostaglandin E1

Cited by 6 publications

References 1 publication

In-Hospital and Short-Term Outcomes of Endovascular Treatment in Patients With Acute Thromboembolic Occlusion of the Superi̇or Mesenteri̇c Artery

In-Hospital and Short-Term Outcomes of Endovascular Treatment in Patients With Acute Thromboembolic Occlusion of the Superi̇or Mesenteri̇c Artery

Successful recanalization of a superior mesenteric artery thrombotic occlusion via a percutaneous rotational thrombectomy

Successful aspiration and thrombolytic therapy for acute superior mesenteric artery occlusion

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