Primary percutaneous aspiration and thrombolysis for the treatment of acute embolic superior mesenteric artery occlusion

Abstract

Primary percutaneous aspiration and thrombolysis constitutes a promising alternative to surgical revascularization in selected patients with acute embolic SMA occlusion.

Endovascular Management of Acute Embolic Occlusion of the Superior Mesenteric Artery: A 12-Year Single-Centre Experience

“…Studies with a low mortality rate included patients without signs of intestinal ischemia [6,16,17]. Conversely, a higher mortality rate was observed in a study in which patients with intestinal ischemia were included [18,19].…”

Thrombolysis for acute occlusion of the superior mesenteric artery

“…12 Because emboli typically are dislodged to the periphery of the SMA in an atherosclerosis-free segment, local pharmacologic thrombolysis has the potential to dissolve the clot completely with minimal trauma to the occluded artery. Saddle embolus lodged distally in the main stem (Fig 2) or fragmented emboli with occlusion of one or several side branches may be treated effectively by lysis from an endhole catheter with its tip located just above or within the main clot to be able to exert lysis downstream to more distal embolic fragments.…”

“…Both of these techniques can be used effectively alone or when combined. 4,12 Most of the study patients received heparin infusion through the introducer sheath during thrombolytic treatment. However, two patients had thrombosis at the intro- ducer site and none of them received heparin infusion through the introducer sheath in conjunction with thrombolysis.…”

Outcome of primary percutaneous stent-revascularization in patients with atherosclerotic acute mesenteric ischemia

“…A hybrid surgical room with facilities for both percutaneous and open surgical intervention can save valuable time (13). This technique was not used in our center for the here reported group.…”