Dang Vy C, Timbalia Shrishiv A, Rahimi Maham
Texas A&M University College of Medicine, Bryan, TX.
Department of Cardiovascular Surgery, Houston Methodist Hospital, Houston, TX.
J Vasc Surg Cases Innov Tech. 2025 May 23;11(4):101857. doi: 10.1016/j.jvscit.2025.101857. eCollection 2025 Aug.
A 58-year-old male in cardiogenic shock requiring a left ventricular assist device and veno-arterial extracorporeal membrane oxygenation with worsening lactic acidosis was found to have acute occlusion of the visceral aorta, celiac axis, superior mesenteric artery (SMA), and left renal artery. We describe the off-label use of the Inari ProTrieve Sheath to prevent distal thromboembolic events during mechanical aortic thrombectomy in a patient on extracorporeal membrane oxygenation who could not tolerate aortic cross-clamping. Retrograde SMA thrombectomy and patch angioplasty was subsequently performed, followed by temporary abdominal closure. The patient's lactic acidosis improved significantly, and repeat imaging revealed a patent aorta and SMA.
一名58岁男性处于心源性休克状态，需要使用左心室辅助装置和静脉-动脉体外膜肺氧合，且乳酸酸中毒不断加重，结果发现其内脏主动脉、腹腔干、肠系膜上动脉（SMA）和左肾动脉急性闭塞。我们描述了Inari ProTrieve鞘在体外膜肺氧合支持下无法耐受主动脉交叉钳夹的患者进行机械性主动脉血栓切除术期间预防远端血栓栓塞事件的非标签使用情况。随后进行了逆行SMA血栓切除术和补片血管成形术，接着进行了临时腹部闭合。患者的乳酸酸中毒显著改善，重复成像显示主动脉和SMA通畅。
