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The thrombus location was classified as proximal, middle, and peripheral based on angiographic findings, and endovascular therapy strategies were selected based on thrombus location. The initial endovascular technique was selected as follows: aspiration embolectomy or antegrade stenting for proximal thrombus, aspiration embolectomy for middle thrombus, and local thrombolysis for peripheral thrombus. Outcomes assessed included technical success (reperfusion of blood flow in the primary occluded superior mesenteric artery segment targeted by endovascular therapy), procedure-related adverse events, bowel necrosis, bowel resection, all-cause 30-day mortality, and acute superior mesenteric artery occlusion-related 30-day mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-three consecutive patients (mean age 76.0\u2009\u00b1\u20098.9\u00a0years; 20 male) were included. The technical success rate was 100%. Procedure-related adverse events occurred in 15.2% patients (four arterial injuries and one distal embolization). Bowel necrosis was observed in 36.4% patients (n\u2009=\u200912), with 33.3% (n\u2009=\u200911) requiring necrotic bowel resection. All bowel necrosis cases were associated with peripheral thrombus. All-cause 30-day mortality and acute superior mesenteric artery occlusion-related 30-day mortality rates were 15.8% (n\u2009=\u20095) and 9.3% (n\u2009=\u20093), respectively. Extensive thrombus involving the peripheral region was significantly associated with bowel necrosis (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). All acute superior mesenteric artery occlusion-related deaths were linked to extensive bowel necrosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Tailored endovascular strategies based on thrombus location may contribute to favorable clinical outcomes in patients with acute superior mesenteric artery occlusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11604-025-01914-2","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T04:39:07Z","timestamp":1764131947000},"page":"698-708","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical outcomes of endovascular therapy strategy based on thrombus location for acute superior mesenteric artery occlusion"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0725-6880","authenticated-orcid":false,"given":"Tatsuo","family":"Ueda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumie","family":"Sugihara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidemasa","family":"Saito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayaka","family":"Shirai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryutaro","family":"Fujitsuna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taiga","family":"Matsumoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misa","family":"Iwasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoji","family":"Yokobori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromitsu","family":"Hayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin-ichiro","family":"Kumita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"1914_CR1","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1016\/j.ejvs.2017.01.010","volume":"53","author":"M Bj\u00f6rck","year":"2017","unstructured":"Bj\u00f6rck M, Koelemay M, Acosta S, Bastos Goncalves F, K\u00f6lbel T, Kolkman JJ, et al. 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This study was approved by the institutional review board of Nippon Medical School Hospital (B-2024-992).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Written informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent\/consent to participate"}},{"value":"Written informed consent was obtained from all individual participants (patients) whose data were included in the study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}}]}}