Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 7, 2022; 10(1): 217-226
Published online Jan 7, 2022. doi: 10.12998/wjcc.v10.i1.217
Superior mesenteric venous thrombosis: Endovascular management and outcomes
Khaled Alnahhal, Beau B Toskich, Samuel Nussbaum, Zhuo Li, Young Erben, Albert G Hakaim, Houssam Farres
Khaled Alnahhal, Samuel Nussbaum, Young Erben, Albert G Hakaim, Houssam Farres, Department of Surgery, Division of Vascular Surgery, Mayo Clinic Florida, Jacksonville, FL 32224, United States
Beau B Toskich, Department of Radiology, Mayo Clinic Florida, Jacksonville, FL 32224, United States
Zhuo Li, Department of Biostatistics, Mayo Clinic Florida, Jacksonville, FL 32224, United States
Author contributions: Alnahhal K, Nussbaum S, and Farres H designed the study; Alnahhal K, Nussbaum S, and Li Z participated in the acquisition, analysis, and interpretation of the data, and drafted the initial manuscript; Toskich BB, Erben YM, Hakaim AG, and Farres H revised the article critically for important intellectual content.
Institutional review board statement: The study was reviewed and approved by the Mayo Clinic Institutional Review Board (Approval No. 19-005202).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare that there are no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Houssam Farres, MD, Doctor, Surgeon, Department of Surgery, Division of Vascular Surgery, Mayo Clinic Florida, 4500 San Pablo Road South, Jacksonville, FL 32224, United States. farres.houssam@mayo.edu
Received: July 16, 2021
Peer-review started: July 16, 2021
First decision: August 19, 2021
Revised: September 5, 2021
Accepted: November 28, 2021
Article in press: November 28, 2021
Published online: January 7, 2022
ARTICLE HIGHLIGHTS
Research background

Superior mesenteric venous thrombosis (SMVT) is a rare but deadly condition with mortality rates of up to 23% that is typically treated with anticoagulation therapy and endovascular treatment if this fails.

Research motivation

Most existing studies looking into endovascular of SMVT are small case series and case reports, and as such more information is needed on treatments for this rare condition.

Research objectives

This study aimed to evaluate patients diagnosed with SMVT who received endovascular therapy in addition to anticoagulation and report technical and clinical outcomes.

Research methods

A retrospective analysis of the patients who underwent endovascular treatment for SMVT at Mayo Clinic from 2000-2019 was performed. We explored the success of these endovascular treatments by determining technical success in each case, defined as any improvement in SMV flow following recanalization, and by assessing the primary/secondary patency rates.

Research results

Twenty-four patients were included for analysis. Of these patients, 19 presented with acute thrombosis, while 5 presented with chronic thrombosis with acute manifestations. The most commonly used endovascular modalities were thrombectomy in 12 patients and catheter-directed thrombolysis in 10 patients. Technical success was achieved in 75% of patients, and the 14-d and 30-d patency rates were 88.9% and 83.3% respectively. The 5-year overall survival rate was 83%.

Research conclusions

Endovascular interventions in addition to anticoagulation therapy appears to be effective in treating SMVT and may be considered a first-line therapy in select patients.

Research perspectives

Our research helps build the base of literature on the rare condition of SMVT by providing an evaluation of the technical and clinical endovascular management outcomes. Larger prospective studies looking into the long-term outcomes of these endovascular interventions and anticoagulation therapy may be a future research direction.