Intra-arterial Fibrinolytic Therapy Using Modified Sullivan Technique in SMA Thromboembolism: a case report

Our aim is to present the role of contrastenhanced 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 rTPA appeared to accelerate clot lysis.