Slow-bolus infusion of r-tPA in the treatment of superior mesenteric artery embolism

Abstract

SUMMARY
Thromboembolic occlusion of the SMA is an uncommon
cause of acute intestinal ischemia that carries a high
mortality. We report 2 cases of SMA embolism, treated with
slow-bolus infusion of r-tPA. Angiography showed a
partially occluded ileiocolic artery in the first patient and
a total proximal occlusion of the SMA in the second patient.
Thrombolytic drugs were selectively injected in both
patients. The clot lysis was complete and the symptoms
disappeared in the first patient. In the second patient clot
lysis was incomplete and thus an extensive enterectomy was
inevitable. Slow-bolus infusion of thrombolytic drugs is an
effective method in carefully selected patients with SMA
embolism.
Key words: Mesenteric ischemia, local fibrinolysis,
mesenteric artery, embolism