Abstract
A 66-year-old man with atrial fibrillation was referred soon after developing left lower limb and abdominal pain with rectal bleeding. An immediate flush aortogram showed embolic occlusion of the left distal superficial femoral artery and superior mesenteric artery (SMA), 3 cm from its ostium. Recombinant tissue plasminogen activitor (rtPA) 40 mg was selectively in stilled in the SMA in two boluses. Abdominal symptoms resolved within 48 h, and complete recanalization of the SMA was shown on angiography. Exploratory laparotomy after 72 h showed a normal small bowel and right colon, and was completed by femoropopliteal embolectomy. Six months later, the patient remained asymptomatic.
Similar content being viewed by others
References
Bigot JM, Chermet J, Sterin P (1982) Le grêle ischémique. In: Nahum H, Geindre M, Bigot JM, Monier JP, Sterin P (eds): Traité de radiodiagnostic. Tome 6, urgences abdominales—grêle—côlon. Masson, Paris, pp. 213–234
Bakal CW, Sprayregen S, Wolf EI (1992) Radiology in intestinal ischemia. Angiographic diagnosis and management. Surg Clin North Am 72(1):125–141
Clark RA, Gallant TE (1984) Acute mesenteric ischemia: Angiographic spectrum. AJR 142:555–562
Mathias K (1990) Angiographic management of intestinal ischemia. In: Dondelinger RF, Rossi P, Kurdziel JC, Wallace S (eds): Interventional radiology. Georg Thieme Verlag, Stuttgart, pp. 645–652
Sicard C, Brenot R, Galtier R, Weiller M, Hussonnois C, David M (1984) Embolie mesentérique supérieure. A propos de deux patients traités avec succès par la streptokinase. J Maladies Vasculaires 9:155–158
Simonetti G, Lupattelli L, Urigo F, Barzi F, Mosca S, Maspes F, Guazzaroni M (1992) La radiologia interventistica nel trattamento dell'ischemia mesenterica acuta e cronica. Radiol Med 84:98–105
Jamieson AC, Thomas RJS, Cade JF (1979) Lysis of a superior mesenteric artery embolus following local infusion of streptokinase and heparin. Aust N Z J Surg 49(3):355–356
Rodde A, Peiffert B, Bazin C, Amrein D, Regent D, Mathieu P (1991) Fibrinolyse intra-artérielle d'une embolie de l'artère mésentérique supérieure. J Radiol 72(4):239–242
Bertal A, Jaafar S, Winants D, Simon JP (1992) Ischémie mésentérique segmentaire d'origine embolique et fibrinolyse. Radiol J Cepur 12(2):43–44
Theiss W, Gullotta U, Bonke S (1982) Behandlung einer Mesenterialarterienembolie durch hochdosierte, lokale Urokinasegabe. VASA 11(3):213–217
Flickinger EG, Johnsrude IS, Ogburn NL, Weaver D, Pories WJ (1983) Local streptokinase infusion for superior mesenteric artery thromboembolism. Am J Roentgenol 140:771–772
Pillari G, Doscher W, Fierstein J, Ross W, Loh G, Berkowitz BJ (1983) Low-dose streptokinase in the treatment of celiac and superior mesenteric artery occlusion. Arch Surg 118:1340–1342
Samama M (1990) Haemorrhagic aspects of thrombolytic therapy. Eur Heart J 11 (suppl F):15–18
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Boyer, L., Delorme, J.M., Alexandre, M. et al. Local fibrinolysis for superior mesenteric artery thromboembolism. Cardiovasc Intervent Radiol 17, 214–216 (1994). https://doi.org/10.1007/BF00571538
Issue Date:
DOI: https://doi.org/10.1007/BF00571538