Goltz Jan P, Petritsch Bernhard, Spor Leo, Hahn Dietbert, Kickuth Ralph
Institute of Radiology, University of Würzburg, Germany.
Vasa. 2012 Sep;41(5):375-9. doi: 10.1024/0301-1526/a000225.
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.
急性肠系膜上动脉血栓栓塞性闭塞是一种罕见且常致命的疾病，手术是其治疗的金标准。我们报告一例患者，该患者在胰腺切除、放疗及肝动脉假性动脉瘤栓塞术后，因肠系膜上动脉急性出血接受覆膜支架植入治疗。数周后，临床症状提示急性肠系膜上动脉血栓栓塞性闭塞，数字减影血管造影显示先前植入的覆膜支架闭塞。该患者使用6F Rotarex®导管经股动脉成功进行了经皮机械性支架内血栓切除术治疗。我们得出结论，在某些特定病例中，经皮机械性血栓切除术可能是治疗急性肠系膜上动脉血栓栓塞性闭塞的一种微创替代开放性手术血栓切除术的方法。
