Acute thromboembolic occlusion of the superior mesenteric artery following covered stent occlusion in the superior mesenteric artery: endovascular therapy using mechanical rotational thrombectomy.
Acute thromboembolic occlusion of the superior mesenteric artery is a rare and often fatal condition in which surgery represents the golden standard in therapy. We present a case in which a patient was treated with covered stent implantation for acute bleeding from the superior mesenteric artery following pancreatic resection, radiation, and embolization of a hepatic artery pseudoaneurysm. Some weeks later clinical signs were suggestive of acute thromboembolic occlusion of the superior mesenteric artery and digital subtraction angiography showed occlusion of the previously implanted covered stents. The patient was successfully treated transfemorally with percutaneous mechanical instent thrombectomy using a 6F Rotarex® catheter. We conclude that in selected cases percutaneous mechanical thrombectomy may represent a minimally-invasive alternative to open surgical thrombectomy for treatment of acute thromboembolic occlusion of the superior mesenteric artery.
Institute of Radiology, University of Würzburg, Germany. goltz@roentgen.uni-wuerzburg.de
Jan P
JP
Goltz
Bernhard
B
Petritsch
Leo
L
Spor
Dietbert
D
Hahn
Ralph
R
Kickuth
D015901:Angiography, Digital Subtraction; D020099:Coated Materials, Biocompatible; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000601:surgery*; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy*; D012086:Reoperation; D015607:Stents; D017131:Thrombectomy / Q000295:instrumentation*; D013923:Thromboembolism / Q000000981:diagnostic imaging / Q000601:surgery*; D013927:Thrombosis / Q000601:surgery*
D020099:Coated Materials, Biocompatible