Superior Mesenteric Artery Embolism Treated Successfully With Rheolytic Thrombectomy and Subsequent Papaverine Infusion

Embolic acute mesenteric ischemia (EAMI) is an uncommon abdominal emergency, but is associated with a high mortality rate. It results from sudden interruption to intestinal blood flow and leads to bowel infarction. Early diagnosis and treatment with prompt laparotomy and embolectomy is the standard treatment. There are reports using percutaneous catheter-based thrombolytic and mechanical clot extraction strategies. One of these methods involves the use of the Angiojet rheolytic thrombectomy system (Boston Scientific), which has been used successfully in other peripheral and visceral arteries in thrombotic conditions. Stenosis due to spasm has been treated with vasodilator therapy with local infusion of intravenous papaverine. We report a case of acute mesenteric ischemia, which was treated with rheolytic thrombectomy followed by local infusion of papaverine.