Endovascular Revascularization of Heavily Calcified Occlusion in Superior Mesenteric Artery using Transcollateral Approach [post]

Kazunori Horie, Akiko Tanaka, Norio Tada
2021 unpublished
BACKGROUND: Mesenteric ischemia is often a manifestation of severe vascular disease involving the superior mesenteric artery (SMA). Endovascular revascularization is still challenging in a chronic total occlusion (CTO) of SMA.CASE PRESENTATION: An-73-year-old male was referred to our hospital because of a 2-year history of abdominal angina after each meal. Computed tomography (CT) images revealed a heavily calcified CTO in the ostium of SMA. Angiography did not show the collateral route
more » ... teral route suitable for transcollateral approach (TCA); however, the three-dimension CT detected pancreaticoduodenal arcade from the celiac artery to the occluded SMA. According to CT imaging, transcollateral wire crossing from the celiac artery was successful in the SMA-CTO. After pull-through of the guide wire, two balloon-expandable stents were deployed in the ostium of SMA. During 3 months after the stent implantation, the patient had no further episodes of abdominal angina on dual-anti-platelet therapyCONCLUSIONS: We demonstrated a case of SMA occlusion with heavy calcification treated with stent implantation using TCA guided by CT imaging.
doi:10.21203/rs.3.rs-406665/v1 fatcat:2dnyd6sbijc2bglrgtc7ym7o2q