Abstract:

At the present level of development of medicine, a group of disorders of mesenteric blood flow remains extremely difficult to diagnose. High mortality at this disease is related to the late detectability, lesion volume, patient's age and the presence of severe comorbidity. However, modern specialized hospitals, with a large arsenal of diagnostic methods, as well as a high level of surgical care in this group of patients apply endovascular interventions for early detection of disease and its possible correction.

Case report describes a clinical case of the female patient A., 58 years old, who was treated at the neurovascular department of Belgorod regional clinical hospital named after St. Ioasaf, with acute stroke of ischemic type in the left hemisphere of the brain, cardioembolic subtype. On the 5th day of hospital treatment, the patient complained on a discomfort and further abdominal pain, bloating - suspected mesenteric ischemia. The patient underwent spiral computed tomography (CT) with bolus-enhansment: diagnosed significant stenosis of celiac trunk (CT), subtotal stenosis of the proximal segment of the superior mesenteric artery (SMA) with signs of local occlusion. As a matter of urgency, in endovascular operating room, patient underwent endovascular procedure: Angiography of visceral branches of the abdominal aorta, followed by thrombectomy and stenting. Control angiography - hemodynamics in the stented segment - is not disturbed, the width of the arterial lumen is fully restored, signs of dissection and distal embolism are absent.

Conclusions: angiographic diagnostic methods in patients with mesenteric arteries thromboembolism is a highly informative, they do not require special preparation of the patient and it can immediately perform a medical intervention. Endovascular diagnosis and treatment can be recommended as a method of choice in the diagnosis and treatment of such severe disease as acute mesenteric thrombosis and thromboembolism. 

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