title: The Use of AngioVac for Symptomatic Aortic Thrombus Complicated by Mesenteric Ischemia.
abstract: Aortic thrombus complicated by mesenteric ischemia is a rare but rather challenging entity. With the recent advancements of endovascular techniques, there is a trend to replace the traditional open surgery with an endovascular approach. We report a patient with paravisceral aortic thrombus involving the celiac artery and superior mesenteric artery (SMA). The patient was complaining of worsening abdominal pain, with clinical findings of leukocytosis, normal lactate, and diagnostic laparoscopy demonstrating a segment of threatened jejunum. We describe the novel use of vacuum-assisted suction filtration device in combination with over-the-wire thrombectomy and stenting to successfully restore blood flow within the SMA. The patient had resolution of her symptoms with improved blood flow to the bowel and no need for resection.
authors.affiliation: Department of Vascular Surgery, Stony Brook University Hospital, Stony Brook, NY. Electronic address: spymonas@gmail.com.
authors.forename: Spyridon
authors.initials: S
authors.lastname: Monastiriotis
authors.affiliation: Department of Vascular Surgery, Stony Brook University Hospital, Stony Brook, NY.
authors.forename: Carl
authors.initials: C
authors.lastname: Gonzales
authors.affiliation: Department of Vascular Surgery, Stony Brook University Hospital, Stony Brook, NY.
authors.forename: Angela
authors.initials: A
authors.lastname: Kokkosis
authors.affiliation: Department of Vascular Surgery, Stony Brook University Hospital, Stony Brook, NY.
authors.forename: Nicos
authors.initials: N
authors.lastname: Labropoulos
authors.affiliation: Department of Vascular Surgery, Stony Brook University Hospital, Stony Brook, NY.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bilfinger
authors.affiliation: Department of Vascular Surgery, Stony Brook University Hospital, Stony Brook, NY.
authors.forename: Apostolos K
authors.initials: AK
authors.lastname: Tassiopoulos
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000368:Aged; D000800:Angioplasty, Balloon / Q000295:instrumentation; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000503:physiopathology; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation; D002445:Celiac Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D000072226:Computed Tomography Angiography; D005260:Female; D006801:Humans; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000503:physiopathology; D065666:Mesenteric Ischemia / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D015607:Stents; D017131:Thrombectomy / Q000295:instrumentation*; D013927:Thrombosis / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D014618:Vacuum; D014654:Vascular Patency