The treatment and outcome of superior mesenteric artery embolism: a hospital-based survey

Abstract Objectives The treatment for superior mesenteric artery embolism is controversial because of the low prevalence of this disease. This study aimed to examine the treatment options for superior mesenteric artery embolism. Methods We retrospectively reviewed the clinical data of twenty patients with superior mesenteric artery embolisms at the Toyohashi Municipal Hospital from April 2010 to March 2020. Clinical characteristics, findings, treatment and outcomes were evaluated. Results The overall median age of the patients was 80 years old. In 16 cases, the obstructed regions of the superior mesenteric artery were proximal to the ileocecal artery bifurcation. Nine cases had pneumatosis intestinalis. Two patients underwent surgery, twelve patients received endovascular intervention and four patients received heparin treatment. Five patients died in the hospital. A comparative study of the outcomes after endovascular intervention showed that the nonsurvivor group had a significantly higher rate of pneumatosis intestinalis than the survivor group (P = 0.046). The patients that had obstructions proximal to the ileocecal artery bifurcation and the presence of pneumatosis intestinalis had a high mortality rate of 60% after endovascular intervention. Conclusions Determining if there is the presence of pneumatosis intestinalis and finding the obstructed region of the superior mesenteric artery are useful for evaluating the appropriate treatment for superior mesenteric artery embolisms.