Acute Superior Mesenteric Artery Embolism With Infective Endocarditis: Is There a Role for Endovascular Treatment?

IF 1.7 2区医学 Q3 PERIPHERAL VASCULAR DISEASE Journal of Endovascular Therapy Pub Date : 2024-11-28 DOI:10.1177/15266028241300927

Xiaoxiang Zhou, Jiao Teng, Zhenjiang Li, Qinglong Zeng, Yangyan He, Yunjun He, Yilang Xiang, Ziheng Wu, Dongling Li, Lu Tian, Hongkun Zhang, Qianqian Zhu

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Abstract

Purpose: The purpose of this article is to report a case of acute superior mesenteric artery embolism due to infective endocarditis treated with endovascular therapy.

Case report: A patient with infective endocarditis was admitted to the hospital with abdominal pain, and abdominal enhanced computer tomography showed acute superior mesenteric artery embolism. He underwent urgent percutaneous mechanical thrombectomy and stenting to open the superior mesenteric artery and restore blood supply to the intestine. However, 17 days after the endovascular treatment, a pseudoaneurysm formed next to the stent, which was eventually removed by open surgery. The patient's prognosis was good at the 1 year follow-up.

Conclusion: Endovascular treatment of acute superior mesenteric artery embolism caused by infective endocarditis was able to rapidly restore the intestinal blood supply. However, the possibility of postoperative pseudoaneurysm needs to be guarded against.

Clinical impact: This study will provide clinical treatment guidance for acute superior mesenteric artery embolism caused by infectious endocarditis. Endovascular treatment may rapidly alleviate intestinal ischemia and reduce the risk of intestinal necrosis, but it cannot completely eliminate infectious emboli, which may lead to further development of pseudoaneurysms.

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急性肠系膜上动脉栓塞伴感染性心内膜炎：血管内治疗有作用吗？

目的：本文旨在报告一例经血管内治疗的因感染性心内膜炎导致的急性肠系膜上动脉栓塞病例：一名感染性心内膜炎患者因腹痛入院，腹部增强计算机断层扫描显示急性肠系膜上动脉栓塞。他紧急接受了经皮机械取栓术和支架植入术，打通了肠系膜上动脉，恢复了肠道供血。然而，血管内治疗 17 天后，支架旁形成了一个假性动脉瘤，最终通过开放手术将其切除。随访一年后，患者预后良好：结论：感染性心内膜炎引起的急性肠系膜上动脉栓塞的血管内治疗能够迅速恢复肠道供血。临床影响：本研究将为感染性心内膜炎引起的急性肠系膜上动脉栓塞提供临床治疗指导。血管内治疗可迅速缓解肠缺血，降低肠坏死风险，但不能完全消除感染性栓子，可能导致假性动脉瘤进一步发展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Endovascular Therapy 医学-外科

CiteScore

5.30

自引率

15.40%

发文量

203

审稿时长

6-12 weeks

期刊介绍： The Journal of Endovascular Therapy (formerly the Journal of Endovascular Surgery) was established in 1994 as a forum for all physicians, scientists, and allied healthcare professionals who are engaged or interested in peripheral endovascular techniques and technology. An official publication of the International Society of Endovascular Specialists (ISEVS), the Journal of Endovascular Therapy publishes peer-reviewed articles of interest to clinicians and researchers in the field of peripheral endovascular interventions.