2025 Volume 34 Issue 1 Pages 25-29
Acute superior mesenteric artery (SMA) ischemia is a life-threatening condition with a high mortality rate, and endovascular therapy is one of its treatment options. The Indigo Aspiration System (Penumbra Inc., Alameda, CA, USA) received approval for reimbursement as a peripheral thrombus aspiration device in September 2023. The patient, a 77-year-old man, presented with acute abdominal pain and was transferred to our hospital following a diagnosis of acute SMA ischemia confirmed by CT scan. Due to signs of peritoneal irritation, we planned an exploratory laparotomy after revascularization via aspiration thrombectomy. An 8 Fr. guide catheter was introduced into the SMA, and angiography revealed an occlusion at the bifurcation of the middle colic artery and the second jejunal artery. Revascularization was successfully achieved. Laparotomy was then performed to assess intestinal viability, revealing necrosis on a portion of the small intestine’s serosal surface. Partial resection of the small intestine was carried out, but the ileal end, ileum, and ascending colon were preserved. A post-operative contrast-enhanced CT scan showed good patency of the SMA, and the patient was discharged on post-operative day 14. The Indigo Aspiration System proved effective for treating acute SMA occlusion.
