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Percutaneous treatment of liver failure and acute mesenteric ischaemia
E M San Norberto1, V M Gutiérrez, J A González-Fajardo
1Division of Vascular Surgery, Valladolid University Hospital, C/ Ramón y Cajal n°3, 47005 Valladolid, Spain. esannorberto@hotmail.com
Insights
Synchronous embolism to the superior mesenteric artery (SMA) and coeliac axis (CA) is rare. Endovascular stent placement successfully treated a patient with acute liver failure, avoiding surgery.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Hepatology
Background:
- Synchronous embolism to the superior mesenteric artery (SMA) and coeliac axis (CA) is an uncommon vascular emergency.
- Acute liver failure can result from compromised visceral artery perfusion.
Observation:
- A 67-year-old male with atrial fibrillation presented with acute liver failure secondary to simultaneous embolic occlusion of the SMA and CA.
- The patient also had a severe coagulopathy.
Findings:
- Successful management was achieved using percutaneous stent placement in the affected arteries.
- An exploratory laparotomy was avoided.
- The patient remained symptom-free at 1-year follow-up with documented stent patency.
Implications:
- Endovascular techniques represent a feasible first-line option for selected patients with visceral artery embolism and liver failure.
- This approach is particularly relevant for patients with no signs of peritonism, early diagnosis, and high surgical risk.
Introduction:
Synchronous embolism to the superior mesenteric artery (SMA) and coeliac axis (CA) is a rare disease.
Report:
A 67-year-old man with atrial fibrillation developed acute liver failure due to an embolic occlusion of the CA and SMA, with a severe coagulation disorder. He was successfully managed with percutaneous stent placement and an exploratory laparotomy was not needed. He remains symptom-free 1 year after the procedure, and duplex follow-up showed stent patency.
Conclusion:
Endovascular techniques in patients with liver failure, no signs of peritonism, early diagnosis and high operative risk seem feasible and should be used if possible, as first-line option.
