Acute pancreatitis after percutaneous mechanical thrombectomy: case report and review of the literature

Cardiovasc Intervent Radiol. 2011 Feb:34 Suppl 2:S25-30. doi: 10.1007/s00270-010-0027-4. Epub 2010 Nov 13.

Abstract

Purpose: We describe a case of severe acute pancreatitis after percutaneous mechanical thrombectomy (PMT) and review the literature for the occurrence of this complication.

Materials and methods: A 53-year-old man with a history of bilateral external iliac artery stent placement sought care for acute onset of lifestyle-limiting left claudication. Angiography confirmed left external iliac stent occlusion, and PMT with the AngioJet Xpeedior catheter (Possis Medical, Minneapolis MN) was performed.

Results: After PMT of the occluded external iliac artery, a residual in-stent stenosis required the placement of a second iliac stent. The procedure was complicated by severe acute pancreatitis. Other causes of pancreatitis were eliminated during the patient's hospital stay. A literature review revealed nine cases of acute pancreatitis after PMT.

Conclusion: Although rare, pancreatitis can be a devastating complication of PMT. The development of pancreatitis seems to be related to the products of extensive hemolysis triggering an inflammatory process. To prevent this complication, we recommend that close attention be paid to the duration and extent of PMT, thereby avoiding extensive hemolysis and subsequent complications.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Angiography
  • Angioplasty / adverse effects*
  • Combined Modality Therapy
  • Equipment Failure
  • Humans
  • Iliac Artery / surgery*
  • Ischemia / diagnosis
  • Ischemia / etiology
  • Leg / blood supply
  • Male
  • Middle Aged
  • Pancreatitis, Acute Necrotizing / diagnosis
  • Pancreatitis, Acute Necrotizing / etiology*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology*
  • Recurrence
  • Reoperation
  • Risk Factors
  • Stents*
  • Thrombectomy / adverse effects*
  • Thrombolytic Therapy / adverse effects
  • Tissue Plasminogen Activator / adverse effects
  • Tissue Plasminogen Activator / therapeutic use
  • Tomography, X-Ray Computed

Substances

  • Tissue Plasminogen Activator