# Case Report: Acute superior mesenteric artery embolism combined with abdominal aortic aneurysm in an elderly female patient

## TL;DR

A rare case of a 78-year-old woman with both acute superior mesenteric artery embolism and abdominal aortic aneurysm is reported, with successful treatment and long-term follow-up.

## Contribution

This case report highlights the rare coexistence and successful management of ASMAE and AAA in a single patient.

## Key findings

- The patient was successfully treated for ASMAE with thrombolysis and mechanical thrombectomy.
- Endovascular aneurysm repair was performed for AAA after resolving inflammation.
- Three-year follow-up showed no complications in SMA patency or AAA stent integrity.

## Abstract

Both acute superior mesenteric artery embolism (ASMAE) and abdominal aortic aneurysm (AAA) are insidious conditions that can lead to fatal outcomes. The coexistence of ASMAE and AAA in a single patient is rare.

A 78-year-old female patient presented to our hospital due to abdominal pain for 10 h, with a diagnosis of AAA 2 h prior. Further evaluation through abdominal aorta computed tomography angiography (CTA) revealed the presence of both ASMAE and AAA. After a comprehensive assessment of her condition, treatment for ASMAE was prioritized. Digital subtraction angiography of the abdominal aorta and superior mesenteric artery (SMA) was performed, followed by local thrombolysis of the SMA embolism and two sessions of AngioJet mechanical thrombectomy. Once inflammation parameters have normalized and an active infection could be excluded, the patient subsequently underwent endovascular aneurysm repair (EVAR) for the AAA. Regular follow-up CTA over three years demonstrated that the SMA remained patent, and the abdominal aortic covered stent was intact, there were no significant endoleaks or thrombosis, with no evidence of stenosis in the abdominal aorta.

The simultaneous occurrence of ASMAE and AAA is uncommon. ASMAE poses a significant threat to life and necessitates urgent treatment. Unruptured AAA can be treated electively once any contraindications have been addressed.