Mak Allison K, Andraska Elizabeth A, Reitz Katherine M, Chaer Rabih, Eslami Mohammed H, Avgerinos Efthymios
University of Pittsburgh School of Medicine, United States.
Department of Surgery, Division of Vascular Surgery, UPMC Heart and Vascular Institute, UPMC Presbyterian Hospital, Room E362.4, South Tower, 200 Lothrop Street, Pittsburgh, PA 15213-2582, United States.
Ann Vasc Surg Brief Rep Innov. 2022 Jun;2(2). doi: 10.1016/j.avsurg.2022.100070. Epub 2022 Apr 4.
Acute mesenteric ischemia (AMI) is typically treated by open surgery or hybrid techniques. Catheter-based aspiration thrombectomy represents another minimally invasive alternative with a potential additional safety benefit of minimizing the bleeding risk associated with thrombolytics. In this institutional case series, we present five clinical cases of aspiration thrombectomy for high-risk AMI using the Penumbra aspiration system. All patients underwent technically successful endovascular thrombectomy as demonstrated by intraoperative angiography results. However, bowel necrosis and sepsis adversely affected postoperative outcomes. Lack of intraoperative bowel assessment is a limitation of endovascular methods, highlighting the importance of patient selection.
急性肠系膜缺血(AMI)通常通过开放手术或杂交技术进行治疗。基于导管的抽吸血栓切除术是另一种微创替代方法,具有将与溶栓剂相关的出血风险降至最低的潜在额外安全益处。在本机构病例系列中,我们展示了使用Penumbra抽吸系统对高危AMI进行抽吸血栓切除术的5例临床病例。术中血管造影结果显示,所有患者均成功进行了血管内血栓切除术。然而,肠坏死和脓毒症对术后结果产生了不利影响。缺乏术中肠道评估是血管内方法的一个局限性,凸显了患者选择的重要性。