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PubMed · 14209922

SUPERIOR MESENTERIC EMBOLECTOMY.

G L BOHN·K J CARROL
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Abstract

This paper reports a successful superior mesenteric embolectomy. The possibility of successful surgical treatment makes its recognition particularly important. In any patient with a known history of cardiovascular disease who presents a sudden severe abdominal pain of obscure origin this diagnosis must be entertained. The pain at first is colicky because of the severe peristalsis which is induced but when ischaemia is marked it then becomes constant. With the crises of pain in the early stages the blood pressure falls and then recovers with the cessation of pain and this intermittent shock was a feature in the patient reported. A plain radiograph of the abdomen in the early stages is characterized by the absence or minimal presence of air in both the small and large bowel giving the film a very clear appearance. Prompt exploration is needed.

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EmbolectomyEmbolismHumansIntermittent ClaudicationIschemiaMesenteric ArteriesMesenteric Vascular OcclusionMesenteryMyocardial InfarctionVascular Surgical ProceduresEMBOLISMINTERMITTENT CLAUDICATIONMESENTERIC ARTERIESMESENTERIC VASCULAR OCCLUSIONMYOCARDIAL INFARCTVASCULAR SURGERYJournal Article

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BibTeXRIS

G L BOHN, K J CARROL. 1964. SUPERIOR MESENTERIC EMBOLECTOMY.. https://doi.org/10.1136/gut.5.4.363

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Preclinical testing of a new clot-retrieving wire device using polyvinyl alcohol hydrogel vascular models.

INTRODUCTION: Cerebral embolism is the principal cause of cerebral infarction. Recently, mechanical embolectomy has been proposed as an effective method. We performed a preclinical evaluation of a new mechanical clot-retrieving wire. METHODS: This clot-retrieving wire consisted of three nitinol loops at the tip of a microguidewire. These three loops could be collapsed into a 0.018-inch wire compatible microcatheter. Each loop was 8 mm long and 3.5 mm wide. For simulation, polyvinyl alcohol (PVA) vascular anatomical models of the human carotid (eight models) and vertebrobasilar (three models) circulation were constructed. A pulsatile flow circulation system was used. Embolic clots were produced using pig blood plasma. The microcatheter and the microguidewire were advanced beyond the clot. The wire was then exchanged for the retrieving wire. The microcatheter was then pulled slightly back to open the loops. The clot was then caught by withdrawal of the system. Once caught, the clot was retrieved to the guiding catheter tip. We investigated the following points: ease of device deployment, clot capture ability, clot removal against blood flow and removal of the clot out of the introducer system. RESULTS: A total of 104 procedures were performed in 11 PVA models and evaluated. The drop rate was 19%. We succeeded in partial and total recanalization in 51.0% of the procedures (53/104) within 30 minutes. CONCLUSION: This new clot-retrieving wire could be useful for mechanical clot extraction in stroke.

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