Non-cavernomatous superior mesenteric thrombosis successfully recanalized with interventional radiological procedures carried out with a combination transmesenteric and transjugular approaches.
This is the study of a 52-year-old man with oesophageal, rectal and anal varices caused by portal hypertension with complete obstruction of the superior mesenteric vein. Treatment by two sessions of interventional radiological procedures was successful. The first was a catheter-directed thrombolysis using the transmesenteric approach. The second was percutaneous transluminal angioplasty and stent implantation for the obstructed segment of the superior mesenteric vein and the creation of a transjugular intrahepatic portosystemic shunt. In the second session, devices were advanced over a guidewire inserted from the right jugular vein and pulled out of the ileocolic vein using the pull-through technique.
Yamagami
T
T
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo, Kyoto, Japan. yamagami@koto.kpu-m.ac.jp
Takeuchi
Y
Y
Sonoyama
T
T
Nakao
N
N
Kato
T
T
Ochiai
T
T
Ichikawa
D
D
Yamagishi
H
H
Nishimura
T
T
D000800:Angioplasty, Balloon / Q000379:methods*; D000925:Anticoagulants / Q000627:therapeutic use; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000601:surgery; D008641:Mesenteric Vascular Occlusion / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000379:methods*; D015642:Radiology, Interventional / Q000379:methods*; D015607:Stents; D015912:Thrombolytic Therapy / Q000379:methods*; D013927:Thrombosis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use
D000925:Anticoagulants; D006493:Heparin; D014568:Urokinase-Type Plasminogen Activator