A single institutional experience with suction thrombectomy in acute mesenteric ischemia

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Gastroenterology

Background:

• Acute mesenteric ischemia (AMI) traditionally requires open surgery or hybrid approaches.
• Minimally invasive catheter-based aspiration thrombectomy is an emerging alternative.
• This technique may reduce bleeding complications associated with thrombolytics.

Purpose of the Study:

• To evaluate the feasibility and outcomes of catheter-based aspiration thrombectomy for high-risk AMI.
• To assess the safety and efficacy of the Penumbra aspiration system in treating AMI.

Main Methods:

• An institutional case series of five patients with high-risk AMI.
• Treatment involved catheter-based aspiration thrombectomy using the Penumbra system.
• Technical success was confirmed by intraoperative angiography.

Main Results:

• All five cases demonstrated technically successful endovascular thrombectomy.
• Postoperative complications included bowel necrosis and sepsis in some patients.
• Intraoperative assessment of bowel viability was not performed.

Conclusions:

• Catheter-based aspiration thrombectomy is technically feasible for high-risk AMI.
• Patient selection is critical to mitigate risks of postoperative bowel necrosis and sepsis.
• The lack of intraoperative bowel assessment is a limitation of current endovascular techniques.