Tsuda Masashi, Nakamura Mamoru, Yamada Yasuo, Saito Haruo, Ishibashi Tadashi, Takahashi Shoki
Department of Radiology, Sendai National Hospital, Sendai, Japan.
J Endovasc Ther. 2003 Oct;10(5):1015-8. doi: 10.1177/152660280301000527.
To report a case of acute superior mesenteric artery (SMA) embolism successfully treated with hydrodynamic thrombectomy and pharmacological thrombolysis.
A 67-year-old man was admitted to the hospital with acute severe abdominal pain. Selective angiography via a femoral puncture revealed a complete embolic occlusion distal to the first jejunal branch of the SMA. Hydrodynamic thrombectomy resolved the severe abdominal pain of the patient in approximately 10 minutes after the start of thrombectomy. Local continuous thrombolysis with urokinase resulted in near complete restoration of the mesenteric flow after 24 hours. The patient made an uneventful recovery and continues to do well on warfarin therapy 8 months after treatment; he has shown no evidence of malabsorption.
Although insertion of the device into the SMA via a femoral puncture is a difficult approach, we propose that hydrodynamic thrombectomy followed by local thrombolysis is a useful treatment for acute superior mesenteric artery embolism.
报告一例成功采用水力血栓切除术和药物溶栓治疗的急性肠系膜上动脉（SMA）栓塞病例。
一名67岁男性因急性严重腹痛入院。经股动脉穿刺进行选择性血管造影显示，在SMA第一空肠分支远端存在完全性栓塞性闭塞。水力血栓切除术在开始血栓切除术后约10分钟缓解了患者的严重腹痛。使用尿激酶进行局部持续溶栓，24小时后肠系膜血流几乎完全恢复。患者顺利康复，治疗8个月后接受华法林治疗，情况良好；未出现吸收不良的迹象。
尽管经股动脉穿刺将装置插入SMA是一种困难的方法，但我们认为，先进行水力血栓切除术，然后进行局部溶栓，是治疗急性肠系膜上动脉栓塞的一种有效方法。
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