Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju 52727, Republic of Korea.
Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon 51472, Republic of Korea.
Medicina (Kaunas). 2023 Oct 24;59(11):1889. doi: 10.3390/medicina59111889.
: Acute mesenteric ischemia (AMI) is a life-threatening condition, and in 50% of patients, AMI is caused by acute superior mesenteric artery (SMA) embolism. Endovascular treatment is increasingly being considered the primary modality in selected cases. Many studies have reported that percutaneous aspiration embolectomy using a guiding catheter and thrombolysis with recombinant tissue plasminogen activator (rtPA) are effective in treating SMA embolism. However, no reports on treating SMA embolism using rtPA administered via a microcatheter exist. : A 64-year-old man with underlying atrial fibrillation presented with acute SMA embolism revealed using computed tomography (CT). rtPA (total 3 mg) was carefully administered into the occluded SMA through a microcatheter. No complications occurred, and complete revascularization of the SMA was revealed on follow-up CT. : Compared with previous reports, this case report reveals that successful revascularization can be achieved using rtPA administered via a microcatheter, with a low dose of rtPA and a short duration of thrombolysis.
急性肠系膜缺血（AMI）是一种危及生命的疾病，50%的患者的 AMI 由急性肠系膜上动脉（SMA）栓塞引起。在选定的病例中，血管内治疗越来越被认为是主要的治疗方式。许多研究报告称，使用引导导管进行经皮抽吸取栓术和使用重组组织型纤溶酶原激活剂（rtPA）溶栓在治疗 SMA 栓塞方面是有效的。然而，目前尚无关于使用微导管给予 rtPA 治疗 SMA 栓塞的报道。
一名 64 岁男性因患有心房颤动而出现急性 SMA 栓塞，通过计算机断层扫描（CT）发现。通过微导管小心地将 rtPA（总量 3mg）注入闭塞的 SMA 中。未发生任何并发症，并且在随访 CT 上显示 SMA 完全再通。
与之前的报告相比，本病例报告表明，使用微导管给予 rtPA 可实现成功的血管再通，rtPA 剂量低，溶栓时间短。
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