J Korean Soc Radiol.  2013 Jun;68(6):459-462. 10.3348/jksr.2013.68.6.459.

Endovascular Treatment of Chronic Mesenteric Ischemia by Crossing of Two Stents in a Patient with Celiacomesenteric Trunk

• Khil EK
• Lee JM

• KMID: 2002896
• DOI: http://doi.org/10.3348/jksr.2013.68.6.459

Abstract

A 73-year-old woman was presented with a 3-month history of postprandial abdominal pain and weight loss. The patient had an anatomic variant of celiacomesenteric trunk (CMT), with complete occlusion of the superior mesenteric artery (SMA) and significant stenosis of the CMT ostium, resulting in chronic mesenteric ischemia. After several unsuccessful attempts at revascularization of the SMA, celiac artery stenting was performed, followed by SMA stent placement through the previously placed stent mesh into the occlusion site. The patient's symptoms completely resolved after treatment.

MeSH Terms

Abdominal Pain
Celiac Artery
Constriction, Pathologic
Female
Humans
Ischemia
Mesenteric Artery, Superior
Stents
Vascular Diseases
Weight Loss
Ischemia
Vascular Diseases

Figure

• 

  Fig. 1 A 73-year-old woman with chronic mesenteric ischemia. A. Selective angiography of CMT shows severe stenosis of trunk (white arrow) and non visualized proximal SMA. B. CMT angiogram after celiac stent placement reveals patent celiac artery flow with no residual stenosis (white arrow) and retrograde filling into mid SMA (black arrow) via pancreaticoduodenal arcade. C. Enhanced sagittal scan after celiac artery stent confirms CMT with patent celiac artery stent (white arrow) and complete occlusion of proximal SMA (black arrow). D. SMA stent was positioned through the prior CA stent into the obstructed SMA and the proximal portion of stent was overlapped in the trunk with the CA stent (white arrow). E. Final aortography shows antegrade flow into the CA and SMA with no residual stenosis. Note.-CA = celiac artery, CMT = celiacomesenteric trunk, SMA = superior mesenteric artery

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