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- Title
Endovascular revascularization of heavily calcified occlusion in superior mesenteric artery using Transcollateral approach.
- Authors
Horie, Kazunori; Tanaka, Akiko; Tada, Norio
- Abstract
Background: Mesenteric ischaemia is often a manifestation of severe vascular disease involving the superior mesenteric artery (SMA). Endovascular revascularization is challenging in a chronic total occlusion (CTO) of SMA. Case presentation: A-73-year-old male patient was referred to our hospital because of a 2-year history of post prandial abdominal angina. Computed tomography (CT) images revealed a heavily calcified CTO in the ostium of SMA and three-dimensional CT (3D-CT) detected pancreaticoduodenal arcade with filling from the celiac artery. Then, endovascular procedure was attempted; however, angiography did not show the collateral route suitable for transcollateral approach. As demonstrated on the CT, we were successful in passing a guidewire through the SMA-CTO via the celiac trunk transcollateral route. After pull-through of the guidewire, two balloon-expandable stents were deployed in the ostium of SMA. During 3 months after stent implantation, the patient had no further episodes of abdominal angina on dual-anti-platelet therapy. Conclusion: We demonstrate a case of a heavily calcified SMA occlusion successfully treated with endovascular stenting employing a transcollateral approach, guided by 3D-CT.
- Subjects
REVASCULARIZATION (Surgery); MESENTERIC artery; VASCULAR diseases; COMPUTED tomography; ABDOMINAL angina
- Publication
CVIR Endovascular, 2021, Vol 4, Issue 1, p1
- ISSN
2520-8934
- Publication type
Case Study
- DOI
10.1186/s42155-021-00232-8