Successful aspiration and thrombolytic therapy for acute superior mesenteric artery occlusion

Byun, Seung Jae; So, Byung Jun

doi:10.4174/jkss.2012.83.2.115

Cited by 6 publications

(2 citation statements)

References 8 publications

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“…Therefore, they performed a percutaneous aspiration thrombectomy, which led to complete revascularization without any additional procedures. However, for branch arteries, the thrombolysis was useful[20].…”

Section: Discussionmentioning

confidence: 99%

Aspiration therapy for acute embolic occlusion of the superior mesenteric artery

Liu

Tong

Hou

et al. 2019

WJG

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BACKGROUND Embolic superior mesenteric artery (SMA) occlusion is associated with high mortality rates. Delayed treatment often leads to serious consequences, including intestinal necrosis, resection, and even patient death. Endovascular repair is being introduced, which can improve clinical symptoms and prognosis and decrease the incidence of exploratory laparotomy. Many reports have described successful endovascular revascularization of embolic SMA occlusion. However, most of those reports are case reports, and there are few reports on Chinese patients. In this paper, we describe the technical and clinical outcomes of aspiration therapy using a guiding catheter and long sheath technique which facilitates the endovascular repair procedure. AIM To evaluate the complications, feasibility, effectiveness, and safety of endovascular treatment for the acute embolic occlusion of the SMA. METHODS This retrospective study reviewed eight patients (six males and two females) from August 2013 to October 2018 at Xuanwu Hospital, Capital Medical University. The patients presented with acute embolic occlusion of the SMA on admission and were initially diagnosed by computed tomography angiography (CTA). The patients who underwent endovascular treatment with a guiding catheter had no obvious evidence of bowel infarct. No intestinal necrosis was identified by gastrointestinal surgeons through peritoneal puncture or CTA. The complications, feasibility, effectiveness, safety, and mortality were assessed. RESULTS Six (75%) patients were male, and the mean patient age was 70.00 ± 8.43 years (range, 60-84 years). The acute embolic occlusion of the SMA was initially diagnosed by CTA. All patients had undertaken anticoagulation primarily, and percutaneous aspiration using a guiding catheter was then undertaken because the emboli had large amounts of thrombus residue. No death occurred among the patients. Complete patency of the suffering artery trunk was achieved in six patients, and defect filling was accomplished in two patients. The in-hospital mortality was 0%. The overall 12-mo survival rate was 100%. All patients survived, and two of the eight patients had complications (the clot broke off during aspiration). CONCLUSION Aspiration therapy is feasible, safe, and beneficial for acute embolic SMA occlusion. Aspiration therapy has many benefits for reducing patients’ death, resolving thrombi, and improving symptoms.

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Section: Discussionmentioning

confidence: 99%

Aspiration therapy for acute embolic occlusion of the superior mesenteric artery

Liu

Tong

Hou

et al. 2019

WJG

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“…It is important that diagnosis and treatment starts as soon as possible in order to improve prognosis. In addition to surgical treatment such as SMA bypass and surgical embolectomy, treatment by IVR has also been carried out in recent years, and there are reports that the result is relatively good [1–5]. Many previous studies used both thrombus aspiration and thrombolysis by urokinase or tissue type plasminogen activator [2–5].…”

Section: Discussionmentioning

confidence: 99%

A case of endovascular treatment for intestinal ischemia due to acute superior mesenteric artery embolism after TEVAR

Tsutsui¹,

Ootani²

2019

Journal of Surgical Case Reports

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Recently, the use of thoracic endovascular aortic repair (TEVAR) for the treatment of aortic aneurysm is increasing. Therefore, complications associated with TEVAR are expected to increase. Here, we present a case of thrombus aspiration and percutaneous transluminal angioplasty (PTA) for superior mesenteric artery (SMA) embolism after TEVAR. A 69-year-old male patient with an aortic arch aneurysm received TEVAR. On the fourth post-operative day, he suddenly complained of strong abdominal pain. Since enhanced computed tomography (CT) showed SMA embolism, we urgently performed thrombus aspiration and PTA in two consecutive days. After these operations, almost all revascularization was achieved, although a partial occlusion remained. As a result, his symptoms improved, and no recurrence occurred. With the increased use of TEVAR, associated embolism may also increase. The combination of thrombus aspiration and PTA could be one effective option for such cases.

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Colon ischemia: A comprehensive review

Maimone

Ceglie

Siersema

et al. 2021

Clinics and Research in Hepatology and Gastroenterology

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Successful aspiration and thrombolytic therapy for acute superior mesenteric artery occlusion

Cited by 6 publications

References 8 publications

Aspiration therapy for acute embolic occlusion of the superior mesenteric artery

Aspiration therapy for acute embolic occlusion of the superior mesenteric artery

A case of endovascular treatment for intestinal ischemia due to acute superior mesenteric artery embolism after TEVAR

Colon ischemia: A comprehensive review

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