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Updated: Jun 3, 2026
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
[Acute superior mesenteric ischemia: a contrast study on short-and mid-term result between stent implantation and
Xi-tong Zhang1, Hong-yi Zhang, Wei Zhang
1Department of Interventional Radiology, the First Hospital of China Medical Univercity, Shenyang 110001, China. zxtjr@sina.com
Objective:
To compare the short-term and medium-term result of stent implantation with pharmaceutical thrombolysis in patients with acute superior mesenteric artery occlusion.
Methods:
From January, 2004 to December, 2008, thirty-five patients diagnosed acute superior mesenteric ischemia, 12 patients treated with stent implantation (interventional therapy group) and 23 patients with pharmaceutical thrombolysis (thrombolytic therapy group). Interventional therapy group treated with balloon dilatation and stent implantation assisted with anticoagulation, antiplatelet and vascular dilation agents. Thrombolytic therapy group used urokinase combined with anticoagulation, antiplatelet and vascular dilation agents. All patients had taken clopidogrel and aspirin orally after discharged and followed up. The clinical effects of both groups were evaluated separately and the Fisher exact test was used to analysis the significant differences.
Results:
In the 23 cases of thrombolytic therapy group, 7 cases was effective, 16 cases was ineffective (7 cases aggravated or died, 9 cases turn to surgical operation). In the 12 cases of interventional therapy group, 10 cases treated with stent implantation (1 case died of acute cardiac infarction 3 days after interventional operation), 2 cases failed in recanalizing. All patients were followed up after discharged (range 1 - 48 months, mean 15 ± 12 months), 1 case in thrombolytic therapy group was stable, 6 cases died of the recurrence of acute superior mesenteric artery occlusion; 7 cases in interventional therapy group was stable, 1 case died of acute cardiac infarction 20 months after interventional operation (intestinal ischemia not appeared), 1 case had intestinal ischemia reoccurred and recovered by superior mesenteric artery thrombolysis.
Conclusions:
In the treatment of acute superior mesenteric ischemia, stent implantation was obviously superior to pharmaceutical thrombolysis in improving intestinal ischemia and survival, therefore it could provided a reliable choice for the patients who had not appeared intestinal necrosis.
Insights
Stent implantation significantly improves outcomes for acute superior mesenteric artery occlusion compared to pharmaceutical thrombolysis, offering a better survival and intestinal ischemia resolution. This interventional therapy is a reliable choice for patients without intestinal necrosis.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Gastroenterology
Background:
- Acute superior mesenteric artery occlusion is a critical condition with high morbidity and mortality.
- Treatment options include pharmaceutical thrombolysis and interventional procedures like stent implantation.
- Comparing the efficacy of these treatments is crucial for optimizing patient outcomes.
Purpose of the Study:
- To compare the short-term and medium-term results of stent implantation versus pharmaceutical thrombolysis for acute superior mesenteric artery occlusion.
- To evaluate the effectiveness in improving intestinal ischemia and patient survival.
Main Methods:
- A comparative study of 35 patients with acute superior mesenteric ischemia from 2004-2008.
- 12 patients underwent stent implantation (interventional therapy group).
- 23 patients received pharmaceutical thrombolysis (thrombolytic therapy group).
- Both groups received anticoagulation, antiplatelet, and vascular dilation agents.
- Follow-up included clinical evaluation and Fisher exact test for statistical analysis.
Main Results:
- Pharmaceutical thrombolysis showed a low success rate (7/23 effective), with many cases progressing to surgery or death.
- Stent implantation achieved recanalization in 10/12 patients, with a lower mortality rate compared to thrombolysis.
- Medium-term follow-up (1-48 months) indicated better stability and survival in the stent implantation group.
Conclusions:
- Stent implantation is demonstrably superior to pharmaceutical thrombolysis for acute superior mesenteric ischemia.
- Interventional therapy significantly improves intestinal ischemia resolution and patient survival.
- Stent implantation offers a reliable treatment option for patients without intestinal necrosis.
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