[Intra-arterial fibrinolytic therapy for acute mesenteric ischemia]

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.