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Percutaneous Mechanical Thrombectomy for Acute Superior Mesenteric Artery Embolism: Preliminary Experience in Five
Zhe Zhang1, Xueming Chen1, Chenyu Li1
1Department of Vascular Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Background:
This study was performed to summarize our experience in treating acute superior mesenteric artery embolism (SMAE) by percutaneous mechanical thrombectomy (PMT).
Methods:
The clinical data of five patients with acute SMAE treated by PMT in our center from October 2015 to May 2018 were retrospectively analyzed. PMT was performed under local anesthesia. Access was established via the femoral artery or brachial artery. Thrombectomy was performed on the superior mesenteric artery using a 6F Rotarex catheter (Straub Medical, Wangs, Switzerland).
Results:
Technical success of PMT was achieved in all five patients; emboli were completely removed in three patients and partially removed in two patients. No PMT-related complications were noted after surgery. Four patients were smoothly discharged from the hospital after their symptoms were relieved. One patient still had symptoms of intestinal ischemia after the operation, and massive small intestinal necrosis was found by exploratory laparotomy. Intestinal resection was performed, and the patient died 4 months later.
Conclusions:
PMT by the Rotarex system is a minimally invasive, safe, and effective technique in removing SMAE. Early application of PMT can avoid intestinal necrosis.
Insights
Percutaneous mechanical thrombectomy (PMT) effectively removed emboli in acute superior mesenteric artery embolism (SMAE) cases. Early PMT application is crucial to prevent intestinal necrosis and improve patient outcomes.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Gastroenterology
Background:
- Acute superior mesenteric artery embolism (SMAE) is a critical condition requiring prompt intervention.
- Traditional treatments carry significant risks and limitations.
- Percutaneous mechanical thrombectomy (PMT) offers a less invasive therapeutic option.
Purpose of the Study:
- To summarize the clinical experience of treating acute SMAE using PMT.
- To evaluate the safety and efficacy of PMT in SMAE management.
- To assess the impact of early PMT intervention on patient outcomes.
Main Methods:
- Retrospective analysis of five patients with acute SMAE treated with PMT.
- PMT performed under local anesthesia via femoral or brachial artery access.
- Utilized a 6F Rotarex catheter for thrombectomy of the superior mesenteric artery.
Main Results:
- Technical success of PMT achieved in all five patients.
- Complete emboli removal in 60% (3/5) and partial removal in 40% (2/5) of cases.
- No PMT-related complications; four patients discharged successfully, one patient experienced intestinal necrosis and mortality.
Conclusions:
- PMT using the Rotarex system is a safe and effective minimally invasive technique for SMAE.
- Early application of PMT can significantly reduce the risk of intestinal necrosis.
- PMT represents a valuable treatment modality for acute SMAE, potentially improving patient survival rates.
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