A 67-year-old female presented to our local emergency department with a newly diagnosed left ventricular (LV) thrombus in the context of takotsubo cardiomyopathy. She had a 3-day history of worsening abdominal pain, nausea and vomiting. Despite her supratherapeutic status (internationalized normal ratio (INR) of 3.9), she was discovered to have a partially occlusive thrombus in the proximal superior mesenteric artery (SMA) extending from the aorta at the level of origin of SMA and dilated small bowel loops on her computed tomography angiogram (CTA). Given her supratherapeutic status and associated comorbidities including morbid obesity, chronic obstructive pulmonary disease (COPD), the patient was considered high risk for laparotomy. A decision was made to revascularized using the lightning aspiration thrombectomy catheter via femoral artery access, with a contingency for bowel exploration post revascularization and stabilization of INR. The intervention required a preliminary stent placement in the right common iliac artery to facilitate guide wire advancement to the aorta. The lightening 7 catheter was then maneuverered to the SMA, facilitating a successful clot removal. The completion angiography revealed optimal SMA flow without any detectable defects or distal vessel embolism. Post-procedure, the patient’s lactate levels decreased to 0.8 (from 1.6), with a resolution of gastrointestinal symptoms, allowing for her discharge without the need for further interventions. This case exemplifies the potential of minimally invasive endovascular technique as a viable and effective treatment modality for acute mesenteric ischemia, particularly in patients where traditional surgical approaches pose significant risks and where there are no signs of peritonism or radiological evidence of advanced bowel ischemia. However, while this case adds valuable insight to the growing body of evidence supporting endovascular approaches, it also highlights the necessity for further research.