title: Superior mesenteric arterial embolism: treatment by trans-catheter thrombo-aspiration.
abstract: A 57-year-old woman with hypertension, mixed mitral valve disease, and atrial fibrillation was admitted to our hospital because of abdominal pain continuing for several hours. On the following day, colonoscopy was performed, and diffuse yellow-white pseudomembranous changes were seen in the right hemicolon, but there were no abnormal findings in the left hemicolon; 24 h after onset, a diagnosis of superior mesenteric arterial embolism was made on the computed tomography (CT) scan findings. Abdominal angiography was performed and showed complete occlusion of the superior mesenteric artery (SMA). Then conservative treatment, using per-catheteric thrombus aspiration, was done, followed by intraarterial injection of tissue type plasminogen activator. After the thrombo-aspiration, the filling deficit of the main artery had disappeared, and the branches on the right side were clearly delineated. After the treatment, the symptoms such as abdominal pain and diarrhea improved accordingly. She was discharged from the hospital 27 days later. Our case suggests that trans-catheter thrombo-aspiration is a possible alternative to open embolectomy for some cases of SMA embolism more than 10 h post-onset.
authors.affiliation: Department of Internal Medicine, Teikyo University Ichihara Hospital, 3426-3 Anesaki, Ichihara 299-0111, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Ogihara
authors.forename: Shingo
authors.initials: S
authors.lastname: Yamamura
authors.forename: Hiroki
authors.initials: H
authors.lastname: Tomono
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Iwabuchi
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ebihara
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Minagawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ogawa
authors.forename: Susumu
authors.initials: S
authors.lastname: Kurosawa
authors.forename: Koji
authors.initials: K
authors.lastname: Yakabi
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakamura
mesh_terms: D002404:Catheterization; D003106:Colon / Q000098:blood supply / Q000473:pathology; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007269:Injections, Intra-Arterial; D017538:Mesenteric Artery, Superior; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008875:Middle Aged; D011859:Radiography; D013396:Suction / Q000379:methods; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator