Pseudoaneurysm as a rare complication in the treatment of superior mesenteric artery embolism via percutaneous mechanical thrombectomy: a case report

Yu, Zuanbiao; Hu, Jiangnan; Lang, Dehai

doi:10.1177/03000605211022941

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…We used only Rotarex in this study because we do not have other debulking systems, such as Solitaire FR or Penumbra, and we think Angiojet thrombectomy systems are off label for SMA occlusion. Additionally, a careful operation should be performed when performing PMT to reduce the incidence of SMA pseudoaneurysm or dissection [ 17 ]. Therefore, we often use an 8-F introducer if the femoral access is appropriate to use a covered stent in the above situation.…”

Section: Discussionmentioning

confidence: 99%

Treatment outcomes in patients with acute thromboembolic occlusion of the superior mesenteric artery

Li,

Liu,

Jin

et al. 2024

J Cardiothorac Surg

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Objectives The goals of this study were to investigate the treatment outcomes of acute thromboembolic occlusion of the superior mesenteric artery (ATOS) and identify prognostic factors after treatment. Methods The clinical data of 62 patients with ATOS between 2013 and 2021 were retrospectively reviewed. Patients were stratified by the treatment strategy, complications and mortality were compared in different group. Results Sixty-two consecutive patients were identified with ATOS. The median patient age was 69 years (interquartile range 58–79 years). Endovascular therapy was initiated in 21 patients, and 4 patients received conservative treatment. Open surgery was performed first in the remaining 37 patients. The technical success rates of the endovascular first group and open surgery group were 90.5% and 97.3%, respectively. One patient in the conservative treatment group had progression of ischemia to extensive bowel necrosis. There was no difference in 30-day mortality between these groups. Predictors of 30-day mortality included initial neutrophil count > 12* 103/dL, age over 60 years old and history of chronic renal insufficiency. Conclusions Endovascular treatment or conservative treatment may be adopted in selected patients who do not exhibit signs and symptoms of bowel necrosis, and close monitoring for bowel necrosis is important. The increase in preoperative neutrophil count, age over 60 years old and history of chronic renal insufficiency were poor prognostic factors.

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Section: Discussionmentioning

confidence: 99%

Treatment outcomes in patients with acute thromboembolic occlusion of the superior mesenteric artery

Li,

Liu,

Jin

et al. 2024

J Cardiothorac Surg

View full text Add to dashboard Cite

show abstract

“…We used only Rotarex in this study because we do not have other debulking systems, such as Solitaire FR or Penumbra, and we think Angiojet thrombectomy systems are off label for SMA occlusion. Additionally, a careful operation should be performed when performing PMT to reduce the incidence of SMA pseudoaneurysm or dissection 19 . Therefore, we often use an 8-F introducer if the femoral access is appropriate to use a covered stent in the above situation.…”

Section: Discussionmentioning

confidence: 99%

Treatment Outcomes in Patients with Acute Thromboembolic Occlusion of the Superior Mesenteric Artery

Li,

Liu,

Jin

et al. 2023

Preprint

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Purpose: The goals of this study were to investigate the treatment outcomes of acute thromboembolic occlusion of the superior mesenteric artery (ATOS) and identify prognostic factors after treatment. Methods: The clinical data of 62 patients with ATOS between 2013 and 2021 were retrospectively reviewed. Results: Sixty-two consecutive patients were identified with ATOS. The medianpatient age was 69 years (interquartile range 58–79 years). Endovascular therapy was initiated in 21 patients, and 4 patients received conservative treatment. Open surgery was performed first in the remaining 37 patients. The technical success rates of the endovascular first group and open surgery group were 90.5% and 97.3%, respectively. One patient in the conservative treatment group had progression of ischemia to extensive bowel necrosis. There was no difference in 30-day mortality between these groups. Predictors of 30-day mortality included a preoperative neutrophil count>12* 103/dL (OR 11.15, p=0.014). Conclusions: Endovascular treatment or conservative treatment may be adopted in selected patients who do not exhibit signs and symptoms of bowel necrosis, and close monitoring for bowel necrosis is important. The increase in preoperative neutrophil count was a poor prognostic factor.

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“…No deleterious effects of endovascular therapy were identified in any patients. Additionally, careful attention should be given when performing mechanical thrombectomy, with the potential risk of SMA pseudoaneurysm formation ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

Outcome Comparison of Endovascular and Open Surgery for the Treatment of Acute Superior Mesenteric Artery Embolism: A Retrospective Study

Cao

Zhang

et al. 2022

Front. Surg.

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BackgroundFew centers have adopted endovascular revascularization for the treatment of superior mesenteric artery embolism (SMAE). We sought to evaluate the efficacy of endovascular therapy for the treatment of SMAE and identify post-treatment prognostic factors.MethodsThe clinical data of 41 patients with acute SMA embolism between 2013 and 2021 were retrospectively reviewed. Patients with mesenteric artery thrombosis, mesenteric venous thrombosis, and who had only conservative treatment were excluded.ResultsForty-one consecutive patients were identified with SMAE (median age, [range] 35–86 years). Endovascular therapy was initiated in 14 patients with no clinical evidence of bowel necrosis, with mainly mechanical thrombectomy, and technical success was achieved in 93%. Endovascular therapy had advantages in duration surgery time, blood loss, bowel rest time, ICU time, and ventilator use. There was no difference in bowel necrosis, length of necrotic bowel resected, or in-hospital mortality between the two groups. An initial white blood cell (WBC) count >15 × 103/dl and neutrophil count >13 × 103/dl were associated with an increased risk of bowel necrosis, and an initial WBC count, renal function, American Society of Anesthesiologists (ASA >3) and necrotic bowel >2 m were associated with increased mortality.ConclusionsEndovascular treatment has altered the management of SMAE, and it may be adopted in selected patients who are not at risk for bowel necrosis. Avoidance of bowel necrosis patients and close monitoring for bowel necrosis are important.

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Pseudoaneurysm as a rare complication in the treatment of superior mesenteric artery embolism via percutaneous mechanical thrombectomy: a case report

Cited by 4 publications

References 12 publications

Treatment outcomes in patients with acute thromboembolic occlusion of the superior mesenteric artery

Treatment outcomes in patients with acute thromboembolic occlusion of the superior mesenteric artery

Treatment Outcomes in Patients with Acute Thromboembolic Occlusion of the Superior Mesenteric Artery

Outcome Comparison of Endovascular and Open Surgery for the Treatment of Acute Superior Mesenteric Artery Embolism: A Retrospective Study

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