PMID- 31650241
OWN - NLM
STAT- MEDLINE
DCOM- 20200417
LR  - 20200417
IS  - 1432-086X (Electronic)
IS  - 0174-1551 (Print)
IS  - 0174-1551 (Linking)
VI  - 43
IP  - 1
DP  - 2020 Jan
TI  - Percutaneous Pharmaco-Mechanical Thrombectomy of Acute Symptomatic Superior 
      Mesenteric Vein Thrombosis.
PG  - 46-54
LID - 10.1007/s00270-019-02354-y [doi]
AB  - PURPOSE: To evaluate the safety and the efficacy of percutaneous 
      pharmaco-mechanical thrombectomy (PPMT) of acute superior mesenteric vein (SMV) 
      thrombosis. METHODS: A database of patients treated between 2011 and 2018 with 
      acute venous mesenteric ischemia (VMI) was reviewed. VMI was diagnosed in the 
      presence of SMV thrombosis and CT evidence of jejunal thickening. All patients 
      presented with mild to moderate peritonism, which allowed surgery to be 
      postponed. Initial treatment consisted of heparinization. PPMT was indicated in 
      case of worsening abdominal pain despite anticoagulation and was performed via a 
      transjugular or transhepatic approach, using a rotational aspiration thrombectomy 
      catheter, followed by transcatheter thrombolysis. Clinical success was defined as 
      symptoms resolution. Technical success was defined as patency of > 50% of SMV at 
      venography and resolution of jejunal thickening. Patients were discharged on 
      lifelong oral anticoagulation (INR 2.5-3.5). Follow-ups were performed using CT 
      and color Doppler ultrasound. RESULTS: Population consisted of eight males, aged 
      37-81 (mean 56.5 years). Causes for thrombosis were investigated. Urokinase 
      infusion time ranged from 48 to 72 h (3,840,000-5,760,000 IU). Clinical and 
      technical success was obtained in all cases. One patient experienced bleeding 
      from the superior epigastric artery and was treated with embolization. One 
      patient died of multi-organ failure after 35 days, despite resolution of SMV 
      thrombosis. In no case was surgery required after PPMT; mean hospitalization was 
      14.1 days (9-24). Mean follow-up of remaining seven patients was 37.7 months 
      (12-84 months). CONCLUSION: PPMT of acute SMV thrombosis seems safe and 
      effective, with an 87.5% long-term survival rate and a 12.5% major complication 
      rate.
FAU - Rabuffi, Paolo
AU  - Rabuffi P
AUID- ORCID: 0000-0001-7261-2717
AD  - Department of Interventional Radiology, "San Giovanni Addolorata" Hospital, Via 
      dell'Amba Aradam 9, 00184, Rome, Italy. paolorabuffi@gmail.com.
FAU - Vagnarelli, Simone
AU  - Vagnarelli S
AD  - Department of Interventional Radiology, "San Giovanni Addolorata" Hospital, Via 
      dell'Amba Aradam 9, 00184, Rome, Italy.
FAU - Bruni, Antonio
AU  - Bruni A
AD  - Department of Interventional Radiology, "San Giovanni Addolorata" Hospital, Via 
      dell'Amba Aradam 9, 00184, Rome, Italy.
FAU - Antonuccio, Gabriele
AU  - Antonuccio G
AD  - Department of Interventional Radiology, "San Giovanni Addolorata" Hospital, Via 
      dell'Amba Aradam 9, 00184, Rome, Italy.
FAU - Ambrogi, Cesare
AU  - Ambrogi C
AD  - Department of Interventional Radiology, "San Giovanni Addolorata" Hospital, Via 
      dell'Amba Aradam 9, 00184, Rome, Italy.
LA  - eng
PT  - Journal Article
DEP - 20191024
PL  - United States
TA  - Cardiovasc Intervent Radiol
JT  - Cardiovascular and interventional radiology
JID - 8003538
RN  - EC 3.4.21.73 (Urokinase-Type Plasminogen Activator)
SB  - IM
MH  - Acute Disease
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Computed Tomography Angiography
MH  - Female
MH  - Humans
MH  - Male
MH  - Mesenteric Ischemia/diagnostic imaging/*drug therapy/*surgery
MH  - Mesenteric Veins/diagnostic imaging/surgery
MH  - Middle Aged
MH  - Phlebography/methods
MH  - Retrospective Studies
MH  - Thrombectomy/*methods
MH  - Treatment Outcome
MH  - Ultrasonography, Doppler, Color
MH  - Urokinase-Type Plasminogen Activator/administration & dosage/therapeutic use
MH  - Venous Thrombosis/diagnostic imaging/*drug therapy/*surgery
PMC - PMC6940318
OTO - NOTNLM
OT  - Acute superior mesenteric vein thrombosis
OT  - Aspirex
OT  - Mesenteric venous ischemia
OT  - Percutaneous mechanical thrombectomy
OT  - Pharmaco-mechanical thrombectomy
OT  - Transcatheter thrombolysis
EDAT- 2019/10/28 06:00
MHDA- 2020/04/18 06:00
PMCR- 2019/10/24
CRDT- 2019/10/26 06:00
PHST- 2019/06/12 00:00 [received]
PHST- 2019/10/03 00:00 [accepted]
PHST- 2019/10/28 06:00 [pubmed]
PHST- 2020/04/18 06:00 [medline]
PHST- 2019/10/26 06:00 [entrez]
PHST- 2019/10/24 00:00 [pmc-release]
AID - 10.1007/s00270-019-02354-y [pii]
AID - 2354 [pii]
AID - 10.1007/s00270-019-02354-y [doi]
PST - ppublish
SO  - Cardiovasc Intervent Radiol. 2020 Jan;43(1):46-54. doi: 
      10.1007/s00270-019-02354-y. Epub 2019 Oct 24.