Acute SMA Thrombosis

Introduction: Acute SMA thrombosis historically has poor outcomes. With the advent of endovascular interventions, the ability to confirm the inflow and outflow after intervention with angiography and advances in ICU care outcomes may have improved. We review our experience with this condition in the past 3 years.

Method(s): Between 2018 and 2021, 12 patients had SMA bowel ischemia. Univariate analysis for preoperative variables, CT variables, and intraoperative variables were preformed to predict survival. All 12 patients presented with abdominal pain. Of these, none were diabetic, 4 were on anticoagulants, 6 were smokers, 4 had AF, 5 had IHD, and 4 had a history of chronic abdominal pain. CT findings illustrate all the patients had proximal obstruction, 6 had concurrent distal obstruction, and 4 had bowel infarction.

Result(s): Our mortality rate was 50% (6 patients). The average LOS for survivors was 20 days and for those that passed away was 2 days. We demonstrate a correlation with smoking and death 6 (100% p = 0.001) and viable small bowel <100 cm 6 (100% p = 0.001). Return to theater was suggested to be protective.

Conclusion(s): Acute SMA ischemia still remains highly morbid. Smoking and viable small bowel <100 cm are strong predictors of death.

Publication History

Article published online:
09 February 2023