Acute superior mesenteric artery embolism: reperfusion with AngioJet hydrodynamic suction thrombectomy and pharmacologic thrombolysis with the EKOS catheter

被引:27
|
作者
Ballehaninna, U. K. [1 ]
Hingorani, A. [1 ]
Ascher, E. [1 ]
Shiferson, A. [1 ]
Marks, N. [1 ]
Aboian, E. [1 ]
Jimenez, R. [1 ]
Jacob, T. [1 ]
McIntyre, T. [1 ]
机构
[1] Maimonides Hosp, Div Vasc Serv, Brooklyn, NY 11219 USA
关键词
superior mesenteric artery embolism; AngioJet; suction thrombectomy; EKOS tissue plasminogen activator catheter; acute mesenteric ischemia; OCCLUSIVE DISEASE; MANAGEMENT; ISCHEMIA; THROMBOEMBOLISM; UROKINASE;
D O I
10.1258/vasc.2011.cr0311
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Acute mesenteric ischemia is commonly treated by surgical exploration and open thrombectomy. Very few reports describe using newer, minimally invasive methods which utilize catheter-based mechanical and pharmacological thrombolysis. Herein, we report a case of acute superior mesenteric embolism successfully treated with AngioJet hydrodynamic mechanical thrombectomy and EKOS catheter pharmacological thrombolysis. A 76-year-old man with new onset atrial fibrillation presented with abdominal pain of 48 hours duration. Subsequent contrast computed tomography scan of the abdomen revealed a filling defect in the superior mesenteric artery (SMA), suggestive of an acute embolus, which was confirmed by SMA angiogram. The AngioJet aspiration device was used for hydrodynamic suction thrombectomy. The repeat angiogram demonstrated only a partial restoration of blood flow, and thus the EKOS tissue plasminogen activator catheter was left in the SMA for continuous thrombolysis. The patient underwent continuous thrombolysis for two days, with two subsequent sessions of angiography. Thereafter, the patient improved symptomatically and serum lactate was normalized. In conclusion, the AngioJet suction thrombectomy and pharmaco-mechanical thrombolysis using the EKOS catheter is associated with minimal morbidity and can be rapidly performed. It may be used as an alternative to open surgical thrombectomy in selected cases of acute SMA embolism.
引用
收藏
页码:166 / 169
页数:4
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