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[Intra-arterial fibrinolytic therapy for acute mesenteric ischemia]
1Service de Radiologie Cardio-Vasculaire, Centre Médico-Chirurgical de l'Europe, 9 bis, rue de Saint Germain, 78560 Le Port Marly.
Journal De Radiologie
|February 27, 2001
Summary
Percutaneous intra-arterial thrombolysis effectively treated mesenteric ischemia caused by embolic occlusion. This minimally invasive approach offers a viable alternative to surgery for selected patients, improving outcomes with prompt intervention.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Gastroenterology
Background:
- Mesenteric ischemia, often caused by embolic occlusion, is a critical condition requiring timely diagnosis and intervention.
- Traditional management may involve surgical exploration, carrying significant risks.
- Minimally invasive techniques are increasingly explored for complex vascular conditions.
Observation:
- A patient presented with acute mesenteric ischemia due to embolic occlusion.
- Initial diagnostic imaging included plain film, ultrasound, CT, and arteriography.
- Selective superior mesenteric artery angiography confirmed the diagnosis.
Findings:
- Percutaneous intra-arterial thrombolysis was performed within 6 hours of symptom onset.
- Post-procedure angiography at 12 hours demonstrated complete resolution of the arterial thrombus.
- The patient showed significant clinical improvement following the procedure.
Implications:
- Early diagnosis and immediate treatment are crucial for patient survival in mesenteric ischemia.
- Intra-arterial thrombolysis with agents like urokinase can be a safe and effective alternative to surgery.
- This approach is particularly beneficial for patients without signs of bowel necrosis, offering a less invasive treatment option.