Percutaneous mechanical thrombectomy of superior mesenteric artery embolism

Abstract

Purpose. Superior mesenteric artery (SMA) embolism is a rare abdominal emergency that commonly leads to bowel infarction and has a very high mortality rate. Prompt recognition and treatment are crucial for successful outcome. Alternative therapeutic approach in patients with acute SMA embolism in median portion of its stem is proposed.

Materials and Methods. Three consecutive cases of successful percutaneous mechanical thrombectomy in acute SMA embolism and up to 45 months follow-up is presented. In one patient a 6F Rotarex® device was used while in others 6F Aspirex® device were used.

Results. All patients had sudden relief of pain after the procedure with no signs of intestinal infarction. Rupture of the small branch of SMA during Aspirex® treatment was successfully treated by coiling and transient paralytic ileus presented in one patient. All 3 patients remained symptom-free with patent SMA during the follow-up period.

Conclusion. Percutaneous mechanical thrombectomy seems to be a rapid and effective treatment of acute SMA embolism in median portion of its stem in absence of bowel necrosis. Follow-up of our patients showed excellent short- and long-term results.