title: Endovascular recanalisation of an acute superior mesenteric artery occlusion. A case report and review of the literature.
abstract: BACKGROUND
  Acute mesenteric ischaemia (AMI) continues to have a high mortality, ranging from 60 to 80%.
  
  
  METHODS
  A 78-year-old male presented with a 20-hour history of abdominal pain, secondary to a superior mesenteric artery (SMA) thromboembolic occlusion diagnosed on computed tomography (CT) angiography. Following confirmation of bowel viability at laparotomy, endovascular intervention using combined thrombolysis, angioplasty and thromboaspiration was performed. Despite successful recanalisation of the occlusion, his condition continued to deteriorate fatally due to progressive sepsis.
  
  
  CONCLUSIONS
  We discuss the role of biphasic CT in diagnosis of AMI, and review the evidence for endovascular interventions now increasingly used in the emergent management of thromboembolic AMI.
  
  
  CONCLUSIONS
  Early diagnosis using CT angiography is essential, as it is highly sensitive in detecting a visceral arterial occlusion. However, laparotomy is often required to accurately determine bowel viability and the need for resection. Endovascular interventions appear to be effective alternatives to open surgery with appropriate patient selection.
authors.affiliation: Department of Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
authors.forename: James G
authors.initials: JG
authors.lastname: McGarry
authors.affiliation: Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
authors.forename: Sinead H
authors.initials: SH
authors.lastname: McEvoy
authors.affiliation: Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
authors.forename: David P
authors.initials: DP
authors.lastname: Brophy
keywords: Acute mesenteric ischaemia; Angioplasty; CT angiography; Endovascular intervention; SMA occlusion; Thrombectomy
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