What does this research mean for the field?

Endovascular aspiration thrombectomy of the superior mesenteric artery for acute mesenteric ischemia yields high technical success (92%), but 90-day mortality remains high (46%) and is independently associated with prolonged procedure times and severe postoperative complications. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the efficacy and clinical outcomes of endovascular aspiration thrombectomy using the Penumbra Indigo system for acute mesenteric ischemia involving the superior mesenteric artery.

August 30, 2026Journal of Endovascular Therapy

Endovascular Aspiration Thrombectomy of the Superior Mesenteric Artery for Treatment of Acute Mesenteric Ischemia: Results From the ENDO-SMA2MI Registry

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Authors

MDMario D’OriaVascular / Pulmonary Vascular SLSandro LepidiVascular Medicine PSPaolo SpathIRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola

Discussion

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Implication

Multicenter observational study demonstrates high technical success but persistent early mortality in acute mesenteric ischemia patients, indicating severe baseline illness.

Key Points

To evaluate the efficacy and clinical outcomes of endovascular aspiration thrombectomy using the Penumbra Indigo system for acute mesenteric ischemia involving the superior mesenteric artery.
Retrospective, observational, multicenter registry study conducted across 10 Italian centers between January 1, 2020, and December 31, 2024.
Included 48 consecutive patients with acute mesenteric ischemia who underwent endovascular aspiration thrombectomy of the superior mesenteric artery.
Assessed primary endpoints of technical success and mortality, alongside secondary endpoints including perioperative complications and hospital/ICU length of stay.
Technical success of the procedure was achieved in 92% of cases (n = 44/48), with 60% receiving aspiration thrombectomy alone and 39% undergoing concurrent open general surgery.
Overall 90-day mortality was 46% (n = 22), with the majority of deaths (n = 19) occurring within the initial 30 days post-intervention; Clavien-Dindo complications >3 occurred in 58% of patients (n = 28).
Multivariable analysis identified procedure duration exceeding 90 minutes (OR 6.3, 95% CI 1.0–37.2, P = .041) and severe postoperative complications with Clavien-Dindo >3 (OR 19.5, 95% CI 3.2–115.5, P < .001) as independent predictors of mortality.

Cite This Study

D’Oria et al. (2026) studied this question.

synapsesocial.com/papers/6a93f0a36c1a8fb52e79cddf https://doi.org/10.1177/15266028261479535

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Implication

Multicenter observational study demonstrates high technical success but persistent early mortality in acute mesenteric ischemia patients, indicating severe baseline illness.

Endovascular Aspiration Thrombectomy of the Superior Mesenteric Artery for Treatment of Acute Mesenteric Ischemia: Results From the ENDO-SMA2MI Registry

Discussion

Member takes

Implication

Key Points

Cite This Study

Endovascular Aspiration Thrombectomy of the Superior Mesenteric Artery for Treatment of Acute Mesenteric Ischemia: Results From the ENDO-SMA2MI Registry

Discussion

Member takes

Implication

Key Points

Cite This Study

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