Hybrid technique to treat superior mesenteric artery occlusion in patients with acute mesenteric ischemia

Chen,Yan; Zhu,Jiechang; Ma,Zhicheng; Dai,Xiangchen; Fan,Hailun; Feng,Zhou; Zhang,Yiwei; Luo,Yudong

doi:10.3892/etm.2015.2413

June-2015 Volume 9 Issue 6

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June-2015 Volume 9 Issue 6

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Article

Hybrid technique to treat superior mesenteric artery occlusion in patients with acute mesenteric ischemia

Authors:
- Yan Chen
- Jiechang Zhu
- Zhicheng Ma
- Xiangchen Dai
- Hailun Fan
- Zhou Feng
- Yiwei Zhang
- Yudong Luo
View Affiliations / Copyright

Affiliations: Department of General Surgery, General Hospital of Tianjin Medical University, Tianjin 300052, P.R. China, Department of General Surgery, Tianjin First Center Hospital, Tianjin 300192, P.R. China
Pages: 2359-2363
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Published online on: April 7, 2015

https://doi.org/10.3892/etm.2015.2413
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Abstract

Acute mesenteric ischemia is a condition with a high mortality rate. In the present study, a novel hybrid technique for the treatment of acute mesenteric ischemia was investigated. The retrospective study population included six patients, of which five were male and one was female, with a mean age of 69 years (age range, 59‑73 years). The hybrid technique involved isolating the superior mesenteric artery (SMA) for cannulation and subsequently performing a fluoroscopically‑assisted embolectomy, retrograde balloon angioplasty and stenting. Intra‑arterial, catheter‑directed thrombolysis was performed if required. Bowels showing evident necrosis were resected, while ischemic bowels with the potential for recovery were left for 48 h before being re‑examined during the second‑look surgery. Retrograde open mesenteric stenting (ROMS) was successfully performed on two patients without bowel resection. Four patients were successfully treated by intra‑arterial catheter‑directed thrombolysis following recanalization of the SMA, and the ischemic bowels had exhibited a full recovery by the second‑look operation. Three patients underwent a massive bowel resection, but did not develop short bowel syndrome. Two patients developed acute renal failure, one of which recovered after 10 days of dialysis, while the other patient succumbed to acute renal failure. In the five surviving patients, the SMA remained patent for the duration of the follow‑up period. Therefore, ROMS was shown to be a viable alternative procedure for emergent SMA revascularization. In addition, intra‑arterial catheter‑directed thrombolysis following recanalization of the SMA was demonstrated as an alternative technique for inhibiting necrosis in bowels with acute mesenteric ischemia.

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1	Schoots IG, Koffeman GI, Legemate DA, Levi M and van Gulik TM: Systematic review of survival after acute mesenteric ischaemia according to disease aetiology. Br J Surg. 91:17–27. 2004. View Article : Google Scholar : PubMed/NCBI
2	Bayrak S, Bektas H, Duzkoylu Y, Guneyi A and Cakar E: Acute abdomen resulting from concurrent thrombosis of celiac trunk and superior mesenteric artery. Case Rep Gastrointest Med. 2014:1427012014.PubMed/NCBI
3	Matsubara K, Obara H and Kitagawa Y: Diagnosis and treatment of embolism and thrombosis of abdominal aorta and superior mesenteric artery. Nihon Rinsho. 72:1289–1293. 2014.PubMed/NCBI
4	Blauw JT, Meerwaldt R, Brusse-Keizer M, Kolkman JJ, Gerrits D and Geelkerken RH: Retrograde open mesenteric stenting for acute mesenteric ischemia. J Vasc Surg. 60:726–734. 2014. View Article : Google Scholar : PubMed/NCBI
5	Nomura Y, Yamaguchi M, Kitagawa A, Okada T, Okita Y and Sugimoto K: Hybrid management of ruptured isolated superior mesenteric artery dissecting aneurysm. J Vasc Surg. 54:1808–1811. 2014. View Article : Google Scholar
6	Milner R, Woo EY and Carpenter JP: Superior mesenteric artery angioplasty and stenting via a retrograde approach in a patient with bowel ischemia - a case report. Vasc Endovascular Surg. 38:89–91. 2004. View Article : Google Scholar : PubMed/NCBI
7	Wyers MC, Powell RJ, Nolan BW and Cronenwett JL: Retrograde mesenteric stenting during laparotomy for acute occlusive mesenteric ischemia. J Vasc Surg. 45:269–275. 2007. View Article : Google Scholar : PubMed/NCBI
8	Stout CL, Messerschmidt CA, Leake AE, Veale WN, Stokes GK and Panneton JM: Retrograde open mesenteric stenting for acute mesenteric ischemia is a viable alternative for emergent revascularization. Vasc Endovascular Surg. 44:368–371. 2010. View Article : Google Scholar : PubMed/NCBI
9	Byun SJ and So BJ: Successful aspiration and thrombolytic therapy for acute superior mesenteric artery occlusion. J Korean Surg Soc. 83:115–118. 2012. View Article : Google Scholar : PubMed/NCBI
10	Malhotra AD, Chander RK and Kim HS: Catheter-directed thrombolysis for acute superior mesentery artery occlusion: a case report with long-term clinical follow-up. J Vasc Interv Radiol. 21:158–160. 2010. View Article : Google Scholar : PubMed/NCBI
11	Okamura S, Fujiwara H, Sonoyama T, Ochiai T, Ikoma H, Kubota T, et al: Management of acute superior mesenteric artery occlusion by thrombolytic therapy. Case Rep Gastroenterol. 3:300–305. 2009. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Hybrid technique to treat superior mesenteric artery occlusion in patients with acute mesenteric ischemia

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