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

Abstract

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.