Short-Term Results of Vascular Interventions for Acute Superior Mesenteric Artery Embolism

This study aimed to retrospectively evaluate the outcomes of endovascular therapy for acute superior mesenteric artery embolism (ASMAE), identify risk factors for intestinal necrosis (IN), and propose a stratified management approach.

Clinical data from November 2019 to December 2024 were analyzed. Univariate and binomial logistic regression analyses identified risk factors for IN and developed a predictive model.

The cohort consisted of 54 patients, with 27 in the IN group and 27 in the non-IN group. Compared to the non-IN group, the IN group had significantly higher white blood cell count (WBC) (17.5 × 10⁹/L vs. 12.1 × 10⁹/L, P = 0.001), C-reactive protein (CRP) levels (190 mg/L vs. 17.9 mg/L, P < 0.001), and creatine kinase (CK) (227 U/L vs. 118 U/L, P = 0.033). Multivariate analysis revealed CRP (β = 0.025, P = 0.006, 95% confidence interval [CI] 1.007-1.043), WBC (β = 0.166, P = 0.044, 95% CI 1.005-1.015), CK (β = 0.008, P = 0.048, 95% CI 1.003-1.015), and rebound tenderness (RT) (β = 2.645, P = 0.033, 95% CI 1.238-160.32) as independent risk factors for IN. The resulting predictive model was: Log(P) = -7.922 + CRP × 0.025 + WBC × 0.181 + CK × 0.008 + 2.645 × (0/1). Performance was evaluated via the receiver operating characteristic curve analysis.

CRP, WBC, CK, and RT are independent risk factors for IN in ASMAE. A stratified management approach, including prompt laparoscopic exploration when IN is suspected, is recommended.

Level IV, Case Series.