title: Transradial approach for transcatheter selective superior mesenteric artery urokinase infusion therapy in patients with acute extensive portal and superior mesenteric vein thrombosis.
abstract: The purpose of this investigation was to assess the feasibility and effectiveness of transradial approach for transcatheter superior mesenteric artery (SMA) urokinase infusion therapy in patients with acute extensive portal and superior mesenteric venous thrombosis. During a period of 7 years, 16 patients with acute extensive thrombosis of the portal (PV) and superior mesenteric veins (SMV) were treated by transcatheter selective SMA urokinase infusion therapy by way of the radial artery. The mean age of the patients was 39.5 years. Through the radial sheath, a 5F Cobra catheter was inserted into the SMA, and continuous infusion of urokinase was performed for 5-11 days (7.1 +/- 2.5 days). Adequate anticoagulation was given during treatment, throughout hospitalization, and after discharge. Technical success was achieved in all 16 patients. Substantial clinical improvement was seen in these 16 patients after the procedure. Minor complications at the radial puncture site were observed in 5 patients, but trans-SMA infusion therapy was not interrupted. Follow-up computed tomography scan before discharge demonstrated nearly complete disappearance of PV-SMV thrombosis in 9 patients and partial recanalization of PV-SMV thrombosis in 7 patients. The 16 patients were discharged 9-19 days (12 +/- 6.0 days) after admission. Mean duration of follow-up after hospital discharge was 44 +/- 18.5 months, and no recurrent episodes of PV-SMV thrombosis developed during that time period. Transradial approach for transcatheter selective SMA urokinase infusion therapy in addition to anticoagulation is a safe and effective therapy for the management of patients with acute extensive PV-SMV thrombosis.
authors.affiliation: Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China. wangmq@vip.sina.com
authors.forename: Mao Qiang
authors.initials: MQ
authors.lastname: Wang
authors.forename: Li Ping
authors.initials: LP
authors.lastname: Guo
authors.forename: Han Ying
authors.initials: HY
authors.lastname: Lin
authors.forename: Feng Yong
authors.initials: FY
authors.lastname: Liu
authors.forename: Feng
authors.initials: F
authors.lastname: Duan
authors.forename: Zhi Jun
authors.initials: ZJ
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D004334:Drug Administration Schedule; D005240:Feasibility Studies; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D017538:Mesenteric Artery, Superior; D008641:Mesenteric Vascular Occlusion / Q000188:drug therapy*; D008642:Mesenteric Veins; D008875:Middle Aged; D011169:Portal Vein; D011677:Punctures / Q000009:adverse effects; D017534:Radial Artery; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*; D020246:Venous Thrombosis / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents; D014568:Urokinase-Type Plasminogen Activator