Angiosurgical method for successful treatment of acute mesenteric thrombosis: A case study

Surgical treatment for acute mesenteric thrombosis remains a pressing medical issue. The prevalence of this condition is growing, leading to increasing interest among general and vascular surgeons, and radiologists. This paper presents a clinical case of successful treatment for acute mesenteric thrombosis. Patient P. (79 years old) was admitted to the surgical department of the Ulyanovsk Regional Clinical Hospital on July 1, 2023, at 5:35 PM., as an emergency with complaints of burning epigastric and mesogastric pain. A computed tomography scan of the abdominal cavity and retroperitoneum with intravenous bolus contrast revealed a filling 55 mm-defect of the superior mesenteric artery 34 mm from the ostium. The distal branches were contrasted promptly. Surgery was performed in the X-ray surgical department. Large thrombi in the main trunk of the iliac artery were fragmented using balloon angioplasty and removed using active aspiration. The control angiogram of the superior mesenteric artery revealed that antegrade blood flow along the main branches was restored. Mural thrombi were locally present but they did not affect blood flow velocity. The patient received 10,000 units of heparin during the surgical procedure. The postoperative period was complicated by the formation of an acute ulcer of the anterior gastric wall, which was treated conservatively. The limitations of traditional surgical treatment indicate the need for angiographic revascularization by means of embolectomy or bypass surgery. Endovascular surgical techniques are gradually being introduced into clinical practice, changing the paradigm of treating acute mesenteric thrombosis. Anticoagulant therapy is the gold standard. However, in cases of its ineffectiveness, angiosurgical interventions are sometimes preferable, as they can significantly improve the survival rate and quality of life for patients with mesenteric thrombosis.