Initial transcatheter thrombolysis for acute superior mesenteric venous thrombosis

Table 1 Clinical characteristics and etiology/risk factors of the acute superior mesenteric vein thrombosis patient cohort n (%)

Variable	Overall	Group 1	Group 2	P value
	(n = 25)	(n = 12)	(n = 13)
Age (yr)1	45.08 ± 11.74	46.69 ± 12.69	43.33 ± 10.88	0.48
Sex
Male	15 (60.0)	9 (75.0)	6 (46.2)	0.23
Female	10 (40.0)	3 (25.0)	7 (53.9)
Primary
Protein C deficiency	2 (8.0)	1 (8.3)	1 (7.7)	1.00
Protein S deficiency	2 (8.0)	0 (0.0)	2 (15.4)	0.48
Antithrombin IIIdeficiency	2 (8.0)	1 (8.3)	1 (7.7)	1.00
Factor V Leiden disorder	1 (4.0)	1 (8.3)	0 (0.0)	0.48
Antiphospholipid syndrome	2 (8.0)	1 (8.3)	1 (7.7)	1.00
No thrombophilia	16 (64.0)	8 (66.7)	8 (61.5)	1.00
Secondary
History of splenectomy	6 (24.0)	4 (33.3)	2 (15.4)	0.38
Other earlier abdominal surgery	6 (24.0)	4 (33.3)	2 (15.4)	0.38
Prior DVT/PE	3 (12.0)	1 (8.3)	2 (15.4)	1.00
Cerebral infarction	4 (16.0)	3 (25.0)	1 (7.7)	0.32
Pancreatitis	2 (8.0)	1 (8.3)	1 (7.7)	1.00
Inflammatory bowel disease	1 (4.0)	1 (8.3)	0 (0.0)	0.48
Oral contraceptive use	3 (12.0)	1 (8.3)	2 (15.4)	1.00
Pregnancy	3 (12.0)	2 (16.7)	1 (7.7)	0.59
Alcohol abuse	4 (16.0)	2 (16.7)	2 (15.4)	1.00
Malignancy	3 (12.0)	1 (8.3)	2 (15.4)	1.00
Cirrhosis/portal hypertension	8 (32.0)	3 (25.0)	5 (38.5)	0.67
Bilharzial cirrhosis	2 (8.0)	1 (8.3)	1 (7.7)	1.00
Non-bilharzial cirrhosis	6 (24.0)	2 (16.7)	4 (30.8)	0.65
Diabetes mellitus	1 (4.0)	1 (8.3)	0 (0.0)	0.48
Hypertension	1 (4.0)	0 (0.0)	1 (7.7)	1.00

¹Analysis was performed by t test or Fisher’s exact test. DVT: Deep vein thrombosis; PE: Pulmonary embolism.

Table 2 Procedure and outcome of transcatheter thrombolysis therapy in group 2 n (%)

Patient No.	Route	Duration of thrombolysis (d)	Lysis degree	Percentage of ischemic bowel at admission (estimated length in cm)	Length of resection (cm)	P value
1	SMA	13	Complete	10 (50)	0
2	PT	14	Partial	20 (100)	0
3	PT	12	Complete	10 (50)	0
4	TI	15	Complete	15 (75)	0
5	TI + SMA	13	Partial	30 (150)	80
6	TI + SMA	12	Partial	20 (100)	50
7	PT	10	Complete	10 (50)	0
8	TI + SMA	11	Complete	20 (100)	0
9	TI + SMA	12	Partial	50 (250)	150
10	SMA	15	Partial	40 (200)	100
11	PT + SMA	12	Complete	15 (75)	0
12	SMA	13	Complete	15 (75)	0
13	TI	14	Partial	25 (125)	0
Average		12.77 ± 1.48		100 (range: 62.5-137.5)	0 (range: 0-65)	0.002

SMA: Superior mesenteric artery access; PT: Percutaneous transhepatic route; TI: Transjugular intrahepatic route.

Table 3 Treatment outcomes of acute superior mesenteric vein thrombosis patients n (%)

Outcome	Overall (n = 25)	Group 1 (n = 12)	Group 2 (n = 13)	P value
Morbidity
Bleeding	4 (16.0)	1 (8.3)	3 (23.1)	0.590
Wound infection	3 (12.0)	3 (25.0)	0 (0.0)	0.100
Acute kidney injury	4 (16.0)	2 (16.7)	2 (15.4)	1.000
Short bowel syndrome	5 (20.0)	5 (41.7)	0 (0.0)	0.020
Secondary portal hypertension	1 (4.0)	1 (8.3)	0 (0.0)	0.480
Cavernous transformation of the portal vein	2 (8.0)	2 (16.7)	0 (0.0)	0.220
Delayed or secondary operation	6 (24.0)	2 (16.7)	4 (30.8)	0.650
Bowel transmural necrosis	2 (8.0)	0 (0.0)	2 (15.4)	0.480
Bowel perforation	1 (4.0)	1 (8.3)	0 (0.0)	0.480
Bowel stricture	3 (12.0)	1 (8.3)	2 (15.4)	1.000
Laparoscopic surgery	4 (16.0)	0 (0.0)	4 (30.8)	0.100
Length of resection (cm)2	100 (range: 0, 155)	155 (105, 200)	0 (0, 65)	< 0.001
Time from treatment to symptom elimination1	12.52 ± 7.85	18.25 ± 7.69	7.23 ± 2.42	< 0.001
Time from admission to enteral or oral nutrition (d)1	14.48 ± 6.98	20.50 ± 5.13	8.92 ± 1.89	< 0.001
Duration of hospitalization in (d)1	31.28 ± 15.51	43.00 ± 13.77	20.46 ± 6.59	< 0.001
Total cost in RNB1	133895.20 ± 90996.47	200020.40 ± 91505.62	72785.60 ± 21828.16	0.001
< 30-d mortality	24 (96.0)	11 (91.7)	0 (0.0)	0.480
1-yr survival	21 (84.0)	9 (75.0)	12 (92.3)	0.320

¹Analysis was performed by t test;

²Mann-Whitney U test; or Fisher’s exact test.