Patients diagnosed with mesenteric artery thrombosis (MAT), a rare and acute abdominal condition that has a fatality rate of about 70 percent, could now be better treated through the application of AngioJet hydrodynamic suction thrombectomy (AngioJet), doctors said.
Hsu Chiao-po (許喬博) of Taipei Veterans General Hospital’s (TVGH) Department of Cardiovascular Surgery said an 80-year-old female patient from Hsinchu City was recently diagnosed with MAT after complaining about abdominal pain accompanied by bloody stools.
The woman already suffered from chronic valvular heart disease, atrial fibrillation and liver cirrhosis, and had a history of liver tumors, Hsu said.
Following her referral to the TVGH for emergency treatment, Hsu said a doctor from the Department of Digestive Surgery was disinclined to treat her conditions by removing her necrotic intestines caused by blood clots, considering the large scope of the resection and her low chance of survival after such surgery.
Nor was the doctor willing to resort to the more traditional method of performing an embolectomy to restore blood flow, Hsu said, given the age of the patient and the high surgical risk.
Carefully weighing the risks and benefits, the doctor subsequently advised the patient to undergo AngioJet therapy, Hsu said.
AngioJet is designed to remove thrombus by streaming a high-pressure saline jet through a device based on the Bernoulli principle, a basic principle of fluid behavior, Hsu said. The method first delivers and disperses clot-dissolving drugs directly into the thrombus through a catheter, and then removes the clot fragments.
He said that although an abdominal exploration operation conducted following the AngioJet and an intestinal vessel reconstruction found the woman’s blood supply to her intestines still remained low, no further necrotic tissue was detected.
After one week of post-operative therapy, the patient was found to have recovered well, with no blood in her stools or abdominal pain, Hsu said.
“Patients with acute arterial occlusion require emergency management. They are advised to adopt the AngioJet after a thorough medical assessment to prevent blood clots from spreading further and damaging their vascular structure,” Hsu said.