A case of superior mesenteric artery embolism successfully treated by combined thrombus retrieval therapy using the CAPTIVE technique.

Acute superior mesenteric artery (SMA) embolism is potentially fatal if intestinal necrosis develops, and prompt revascularization is essential. Although thrombolytic therapy and aspiration thrombectomy are commonly employed, thrombolysis is contraindicated in patients with hemorrhagic lesions. We report the application of the continuous aspiration prior to intracranial vascular embolectomy (CAPTIVE) technique in an elderly woman with acute SMA embolism complicated by hemorrhagic stroke. Mechanical thrombectomy using a React 71 aspiration catheter and Solitaire stent retriever was performed under proximal balloon flow control. Staged thrombectomy of the jejunal and ileal branches achieved wide recanalization with a limited number of passes, avoiding intestinal necrosis. This case highlights the feasibility of adapting an established neuroendovascular technique to visceral arterial occlusion. The CAPTIVE technique may represent a minimally invasive alternative in selected patients in whom thrombolytic therapy is not indicated.