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Transradial Approach for Transcatheter Selective Superior Mesenteric Artery Urokinase Infusion Therapy in Patients with Acute Extensive Portal and Superior Mesenteric Vein Thrombosis

CardioVascular and Interventional Radiology volume 33, pages 80–89 (2010)Cite this article

Abstract

The purpose of this investigation was to assess the feasibility and effectiveness of transradial approach for transcatheter superior mesenteric artery (SMA) urokinase infusion therapy in patients with acute extensive portal and superior mesenteric venous thrombosis. During a period of 7 years, 16 patients with acute extensive thrombosis of the portal (PV) and superior mesenteric veins (SMV) were treated by transcatheter selective SMA urokinase infusion therapy by way of the radial artery. The mean age of the patients was 39.5 years. Through the radial sheath, a 5F Cobra catheter was inserted into the SMA, and continuous infusion of urokinase was performed for 5–11 days (7.1 ± 2.5 days). Adequate anticoagulation was given during treatment, throughout hospitalization, and after discharge. Technical success was achieved in all 16 patients. Substantial clinical improvement was seen in these 16 patients after the procedure. Minor complications at the radial puncture site were observed in 5 patients, but trans-SMA infusion therapy was not interrupted. Follow-up computed tomography scan before discharge demonstrated nearly complete disappearance of PV–SMV thrombosis in 9 patients and partial recanalization of PV–SMV thrombosis in 7 patients. The 16 patients were discharged 9–19 days (12 ± 6.0 days) after admission. Mean duration of follow-up after hospital discharge was 44 ± 18.5 months, and no recurrent episodes of PV–SMV thrombosis developed during that time period. Transradial approach for transcatheter selective SMA urokinase infusion therapy in addition to anticoagulation is a safe and effective therapy for the management of patients with acute extensive PV–SMV thrombosis.

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Acknowledgments

Supported by grant from the National Scientific Foundation Committee of China (Grant No. 30670606) and from the Chinese PLA Scientific Foundation of the Eleventh-Five Programme (Grant No. 06MA263).

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  1. Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, 100853, China

    Mao Qiang Wang, Li Ping Guo, Han Ying Lin, Feng Yong Liu, Feng Duan & Zhi Jun Wang

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  1. Mao Qiang Wang
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  2. Li Ping Guo
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  3. Han Ying Lin
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  5. Feng Duan
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  6. Zhi Jun Wang
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Correspondence to Mao Qiang Wang.

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Wang, M.Q., Guo, L.P., Lin, H.Y. et al. Transradial Approach for Transcatheter Selective Superior Mesenteric Artery Urokinase Infusion Therapy in Patients with Acute Extensive Portal and Superior Mesenteric Vein Thrombosis. Cardiovasc Intervent Radiol 33, 80–89 (2010). https://doi.org/10.1007/s00270-009-9777-2

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  • DOI: https://doi.org/10.1007/s00270-009-9777-2

Keywords

  • Interventional radiology
  • Transradial approach
  • Portal vein
  • Superior mesenteric vein
  • Thrombosis
  • Superior mesenteric artery