2004
DOI: 10.1007/s00270-004-0461-2
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Emergent Treatment of Acute Embolic Superior Mesenteric Ischemia with Combination of Thrombolysis and Angioplasty: Report of Two Cases

Abstract: We successfully revascularized the acutely occluded superior mesenteric artery (SMA), caused by a thromboembolus, with a combination of thrombolysis and percutaneous transluminal angioplasty (PTA) in 2 patients. Considerable percent luminal reduction (>90%) was still observed after thrombolysis in both patients. Subsequent adjunctive balloon angioplasty produced sufficient luminal diameter of the SMA (<20% luminal reduction). No serious acute procedural complication occurred. The time from onset to partial rep… Show more

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Cited by 15 publications
(7 citation statements)
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“…However, endovascular therapy shows good results and it is an attractive option to address SMA dissection, as illustrated in this report as well as other series 11,12…”
Section: Discussionsupporting
confidence: 63%
“…However, endovascular therapy shows good results and it is an attractive option to address SMA dissection, as illustrated in this report as well as other series 11,12…”
Section: Discussionsupporting
confidence: 63%
“…Four of five patients (80%) who exhibited complete occlusion of the SMA died (patients #3, 4, 10, and 12). Four of nine patients (44%) who presented symptoms for more than 12 h survived (patients #8, 11,13,14); in one of these four surviving patients bowel resection was carried out (patient #8). Surviving patients were discharged from hospital after a median stay of 16 days (range 8-29 days) after endovascular intervention and none of the surviving patients exhibited short-bowel syndrome.…”
Section: Resultsmentioning
confidence: 99%
“…In addition, CT depicted signs of ileus (dilated and/or fluid/air-filled bowel loops as well as ascites), thickening of bowel wall as well as pneumatosis intestinalis in seven (patients #2, 4, 8-10, 13, 15), six (patients #2-4, 8, 9, 14), and one patient (patient #3), respectively. CT identified synchronous emboli in vascular territories other than the SMA in four patients (patients #7, 8,11,12).…”
Section: Diagnostic Workupmentioning
confidence: 98%
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“…According to a few previous reports [11, 12], adjunctive balloon angioplasty successfully recanalized SMA thrombo‐embolism with failed thrombolysis. Interventional cardiologists, however, may not necessarily prefer this strategy because the disaster of major distal embolization after balloon angioplasty for thrombus containing lesion in coronary artery seems to be the most likely complication [13, 14].…”
Section: Discussionmentioning
confidence: 99%