Endovascular Management of Acute Embolic Occlusion of the Superior Mesenteric Artery: A 12-Year Single-Centre Experience

作者：Raupach J^*; Lojik M; Chovanec V; Renc O; Strycek M; Dvorak P; Hoffmann P; Gunka I; Ferko A; Ryska P; Omran N; Krajina A; Cabelkova P; Cermakova E; Maly R

来源：CardioVascular and Interventional Radiology, 2016, 39(2): 195-203.

DOI：10.1007/s00270-015-1156-6

• Acute intestinal ischemia
• Superior mesenteric artery occlusion
• Endovascular repair
• Aspiration
• Mesenteric artery stenting

Retrospective evaluation of 12-year experience with endovascular management of acute mesenteric ischemia (AMI) due to embolic occlusion of the superior mesenteric artery (SMA).
From 2003 to 2014, we analysed the in-hospital mortality of 37 patients with acute mesenteric embolism who underwent primary endovascular therapy with subsequent on-demand laparotomy. Transcatheter embolus aspiration was used in all 37 patients (19 women, 18 men, median age 76 years) with embolic occlusion of the SMA. Adjunctive local thrombolysis (n = 2) and stenting (n = 2) were also utilised.
We achieved complete recanalization of the SMA stem in 91.9 %. One patient was successfully treated by surgical embolectomy due to a failed endovascular approach. Subsequent exploratory laparotomy was performed in 73.0 % (n = 27), and necrotic bowel resection in 40.5 %. The total in-hospital mortality was 27.0 %.
Primary endovascular therapy for acute embolic SMA occlusion with on-demand laparotomy is a recommended algorithm used in our centre to treat SMA occlusion. This combined approach for the treatment of AMI is associated with in-hospital mortality rate of 27.0 %.

• 出版日期2016-2