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Case report: ultrasound assisted catheter directed thrombolysis of an embolic partial occlusion of the superior mesenteric artery

Acute mesenteric ischemia (AMI) is a severe medical condition defined by insufficient vascular supply to the small bowel through mesenteric vessels, resulting in necrosis and eventual gangrene of bowel walls. We present the case of a 64-year-old man with recrudescence of prolonged epigastric pain at...

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Autores principales: Bongiovanni, Simone, Bozzolo, Marco, Amabile, Simone, Peano, Enrico, Balderi, Alberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10365118/
https://www.ncbi.nlm.nih.gov/pubmed/37492380
http://dx.doi.org/10.3389/fradi.2023.1167901
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author Bongiovanni, Simone
Bozzolo, Marco
Amabile, Simone
Peano, Enrico
Balderi, Alberto
author_facet Bongiovanni, Simone
Bozzolo, Marco
Amabile, Simone
Peano, Enrico
Balderi, Alberto
author_sort Bongiovanni, Simone
collection PubMed
description Acute mesenteric ischemia (AMI) is a severe medical condition defined by insufficient vascular supply to the small bowel through mesenteric vessels, resulting in necrosis and eventual gangrene of bowel walls. We present the case of a 64-year-old man with recrudescence of prolonged epigastric pain at rest of few hours duration, cold sweating and episodes of vomiting. A computed tomography scan of his abdomen revealed multiple filling defects in the mid-distal part of the superior mesenteric artery (SMA) and the proximal part of jejunal branches, associated with small intestine walls thickening, suggesting SMA thromboembolism and initial intestinal ischemia. Considering the absence of signs of peritonitis at the abdominal examination and the presence of multiple arterial emboli was decided to perform an endovascular treatment with ultrasound assisted catheter-directed thrombolysis with EkoSonic Endovascular System—EKOS, which resulted in complete dissolution of the multiple emboli and improved blood flow into the intestine wall. The day after the procedure the patient's pain improved significantly and 5 days after he was discharged home asymptomatic on warfarin anticoagulation. After 1 year of follow-up the patient is fine with no further episodes of mesenteric ischemia or other embolisms.
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spelling pubmed-103651182023-07-25 Case report: ultrasound assisted catheter directed thrombolysis of an embolic partial occlusion of the superior mesenteric artery Bongiovanni, Simone Bozzolo, Marco Amabile, Simone Peano, Enrico Balderi, Alberto Front Radiol Radiology Acute mesenteric ischemia (AMI) is a severe medical condition defined by insufficient vascular supply to the small bowel through mesenteric vessels, resulting in necrosis and eventual gangrene of bowel walls. We present the case of a 64-year-old man with recrudescence of prolonged epigastric pain at rest of few hours duration, cold sweating and episodes of vomiting. A computed tomography scan of his abdomen revealed multiple filling defects in the mid-distal part of the superior mesenteric artery (SMA) and the proximal part of jejunal branches, associated with small intestine walls thickening, suggesting SMA thromboembolism and initial intestinal ischemia. Considering the absence of signs of peritonitis at the abdominal examination and the presence of multiple arterial emboli was decided to perform an endovascular treatment with ultrasound assisted catheter-directed thrombolysis with EkoSonic Endovascular System—EKOS, which resulted in complete dissolution of the multiple emboli and improved blood flow into the intestine wall. The day after the procedure the patient's pain improved significantly and 5 days after he was discharged home asymptomatic on warfarin anticoagulation. After 1 year of follow-up the patient is fine with no further episodes of mesenteric ischemia or other embolisms. Frontiers Media S.A. 2023-05-18 /pmc/articles/PMC10365118/ /pubmed/37492380 http://dx.doi.org/10.3389/fradi.2023.1167901 Text en © 2023 Bongiovanni, Bozzolo, Amabile, Peano and Balderi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Radiology
Bongiovanni, Simone
Bozzolo, Marco
Amabile, Simone
Peano, Enrico
Balderi, Alberto
Case report: ultrasound assisted catheter directed thrombolysis of an embolic partial occlusion of the superior mesenteric artery
title Case report: ultrasound assisted catheter directed thrombolysis of an embolic partial occlusion of the superior mesenteric artery
title_full Case report: ultrasound assisted catheter directed thrombolysis of an embolic partial occlusion of the superior mesenteric artery
title_fullStr Case report: ultrasound assisted catheter directed thrombolysis of an embolic partial occlusion of the superior mesenteric artery
title_full_unstemmed Case report: ultrasound assisted catheter directed thrombolysis of an embolic partial occlusion of the superior mesenteric artery
title_short Case report: ultrasound assisted catheter directed thrombolysis of an embolic partial occlusion of the superior mesenteric artery
title_sort case report: ultrasound assisted catheter directed thrombolysis of an embolic partial occlusion of the superior mesenteric artery
topic Radiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10365118/
https://www.ncbi.nlm.nih.gov/pubmed/37492380
http://dx.doi.org/10.3389/fradi.2023.1167901
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