Local fibrinolysis for superior mesenteric artery thromboembolism.
A 66-year-old man with atrial fibrillation was referred soon after developing left lower limb and abdominal pain with rectal bleeding. An immediate flush aortogram showed embolic occlusion of the left distal superficial femoral artery and superior mesenteric artery (SMA), 3 cm from its ostium. Recombinant tissue plasminogen activator (rtPA) 40 mg was selectively instilled in the SMA in two boluses. Abdominal symptoms resolved within 48 h, and complete recanalization of the SMA was shown on angiography. Exploratory laparotomy after 72 h showed a normal small bowel and right colon, and was completed by femoropopliteal embolectomy. Six months later, the patient remained asymptomatic.
Service de Radiologie, Centre Hospitalier Universitaire, Clermont-Ferrand, France.
L
L
Boyer
J M
JM
Delorme
M
M
Alexandre
A
A
Boissier
P
P
Gimbergues
G
G
Glanddier
J F
JF
Viallet
D000368:Aged; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015641:Radiography, Interventional; D013923:Thromboembolism / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
D010959:Tissue Plasminogen Activator