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Microcatheter-Directed Thrombolysis Using Recombinant Tissue Plasminogen Activator for the Treatment of Acute Superior Mesenteric Artery Embolism: A Case Reportopen access

Authors
Kim, Yang-WonChoi, Ho-CheolYang, Won-JeongKoo, Byeong-JuAhn, Jae-KyeongLee, Jeong-PyoNa, Jae-BumJo, Sa-HongPark, Sung-EunWon, Jung-Ho
Issue Date
Nov-2023
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Keywords
acute mesenteric ischemia; embolectomy; endovascular treatment; revascularization; superior mesenteric artery; thrombolysis
Citation
Medicina (Kaunas, Lithuania), v.59, no.11
Indexed
SCIE
SCOPUS
Journal Title
Medicina (Kaunas, Lithuania)
Volume
59
Number
11
URI
https://scholarworks.gnu.ac.kr/handle/sw.gnu/68617
DOI
10.3390/medicina59111889
ISSN
1010-660X
1648-9144
Abstract
Background: Acute mesenteric ischemia (AMI) is a life-threatening condition, and in 50% of patients, AMI is caused by acute superior mesenteric artery (SMA) embolism. Endovascular treatment is increasingly being considered the primary modality in selected cases. Many studies have reported that percutaneous aspiration embolectomy using a guiding catheter and thrombolysis with recombinant tissue plasminogen activator (rtPA) are effective in treating SMA embolism. However, no reports on treating SMA embolism using rtPA administered via a microcatheter exist. Case presentation: A 64-year-old man with underlying atrial fibrillation presented with acute SMA embolism revealed using computed tomography (CT). rtPA (total 3 mg) was carefully administered into the occluded SMA through a microcatheter. No complications occurred, and complete revascularization of the SMA was revealed on follow-up CT. Conclusions: Compared with previous reports, this case report reveals that successful revascularization can be achieved using rtPA administered via a microcatheter, with a low dose of rtPA and a short duration of thrombolysis.
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