A case of endovascular treatment for intestinal ischemia due to acute superior mesenteric artery embolism after TEVAR.

IF 0.5 Q4 SURGERY Journal of Surgical Case Reports Pub Date : 2019-06-14 eCollection Date: 2019-06-01 DOI:10.1093/jscr/rjz185
Masahiro Tsutsui, Norihumi Ootani
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Abstract

Recently, the use of thoracic endovascular aortic repair (TEVAR) for the treatment of aortic aneurysm is increasing. Therefore, complications associated with TEVAR are expected to increase. Here, we present a case of thrombus aspiration and percutaneous transluminal angioplasty (PTA) for superior mesenteric artery (SMA) embolism after TEVAR. A 69-year-old male patient with an aortic arch aneurysm received TEVAR. On the fourth post-operative day, he suddenly complained of strong abdominal pain. Since enhanced computed tomography (CT) showed SMA embolism, we urgently performed thrombus aspiration and PTA in two consecutive days. After these operations, almost all revascularization was achieved, although a partial occlusion remained. As a result, his symptoms improved, and no recurrence occurred. With the increased use of TEVAR, associated embolism may also increase. The combination of thrombus aspiration and PTA could be one effective option for such cases.

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血管内治疗急性肠系膜上动脉栓塞术后肠缺血1例。
近年来,胸腔血管内主动脉修复术(TEVAR)治疗主动脉瘤的应用越来越多。因此,与TEVAR相关的并发症预计会增加。在此,我们报告一例经皮腔内血管成形术(PTA)治疗TEVAR术后肠系膜上动脉(SMA)栓塞。一名69岁男性主动脉弓动脉瘤患者接受TEVAR治疗。术后第四天,他突然抱怨腹部剧痛。由于增强计算机断层扫描(CT)显示SMA栓塞,我们紧急进行了血栓抽吸和PTA连续两天。在这些手术后,尽管仍然存在部分闭塞,但几乎所有的血运重建都实现了。结果,他的症状得到改善,没有复发。随着TEVAR使用的增加,相关栓塞也可能增加。血栓抽吸联合PTA可能是治疗此类病例的有效选择。
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来源期刊
CiteScore
0.70
自引率
0.00%
发文量
559
审稿时长
11 weeks
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