2023 年 37 巻 2 号 p. 110-116
Acute mesenteric arterial occlusion (AMAO) is caused by a disturbance of blood flow in the superior mesenteric artery (SMA). AMAO is classified into two main categories based on the mechanism of occlusion: SMA embolism and SMA thrombosis. Both conditions present with rapid intestinal ischemia and have a high mortality rate of more than 30% within 30 days of onset. In AMAO, (1) revascularization and (2) evaluation of the ischemic intestinal tract (± resection of the necrotic intestinal tract) are the two mainstays of the acute treatment strategy. In revascularization for AMAO, recent meta-analyses have indicated that endovascular treatment tends to have a lower bowel resection and mortality rates than open revascularization. Endovascular treatment for AMAO as minimally invasive therapy is expected to increase in the super-aging society. It is crucial that IVR physicians, who can contribute to the diagnostic imaging and endovascular treatment, are familiar with this disease and play a central role in the team.