Intra-arterial Fibrinolytic Therapy Using Modified Sullivan Technique in SMA Thromboembolism: A Case Report

修改Sullivan方法之經動脈內上腸系膜動脈血栓溶栓術：病例報告

黃華思(Hua-Tzu Huang) ； 白玉林(Yu-Lin Pai) ； 黃明和(Min-Ho Huang) ； 楊志宗(Jyh-Chung Yang) ； 周德敖(Dev-Aur Chou)

《中華放射線醫學雜誌》 28卷1期 (2003/02) Pp. 31-36

摘要

本篇提出加顯影劑之電腦斷層影像對於早期診斷上腸繫膜動脈血栓栓塞之角色以及報告施行動脈內血栓溶栓術之經驗。在所有三例個案中，加顯影劑之電腦斷層影像皆可清楚顯示血栓栓塞位於上腸繫膜動脈主幹上。於前二例個案，施行栓塞內高劑量血栓溶栓劑（recombinant tissue plasminogen activator, r-TPA）直接注射，接著經唧筒注射血栓溶栓劑；而第三個案只施行經唧筒注射血栓溶栓劑。血栓溶栓治療於前二例個案結果完全成功，而第三個案治療失敗。因此在我們有限的經驗中，加顯影劑之電腦斷層影像能夠幫助早期診斷上腸繫膜動脈血栓栓塞以及施行栓塞內高劑量血栓溶栓劑（r-TPA）直接注射能夠加速血栓之溶解。

關鍵字

血栓溶栓術 ； 血栓栓塞 ； 上腸繫膜動脈

並列摘要

Our aim is to present the role of contrast-enhanced CT in the early diagnosis of superior mesenteric artery (SMA) thromboembolism and to report our experience in the fibrinolytic therapy of this disorder using modified Sullivan technique. Contrast-enhanced helical CT clearly demonstrated the various findings of SMA thromboembolism in all 3 cases. In the first 2 patients, the modified Sullivan method of transthrombus high dose bolus technique followed by pump infusion of recombinant tissue plasminogen activator (r-TPA) was used. In the third case, only pump infusion of r-TPA was done. Fibrinolytic therapy was successful in the first 2 patients but failed in the third. In our limited experience, contrast-enhanced CT was helpful in the early diagnosis of SMA thromboembolism and the intrathrombus high dose bolus technique using r-TPA appeared to accelerate clot lysis.

並列關鍵字

Fibrinolysis ； Thromboembolism ； Superior mesenteric artery