Percutaneous Transcollateral Retrograde Recanalization of Isolated Dissection of the Superior Mesenteric Artery

Abstract

Endovascular stent placement (ESP) for patient with spontaneous isolated dissection of the superior mesenteric artery (SIDSMA) is a widely accepted treatment option. However, failed percutaneous ESP is not uncommon and is one of the leading causes for laparotomy. We report a case of 63-year-old man with SIDSMA encountered failed antegrade recanalization via conventional transfemoral approach. We achieved recanalization in a retrograde fashion through middle colic artery using rendezvous technique and successfully placed self-expandable stents inside the dissected superior mesenteric artery. The patient recovered well after percutaneous ESP. We herein describe the transcollateral retrograde approach of percutaneous ESP for SIDSMA as an alternative option when conventional antegrade recanalization fails.

Spontaneous isolated superior mesenteric artery dissection: A case report and brief analysis

“…Overall, there are numerous other studies [20] , [21] , [22] , [23] , [24] which suggest that conservative management with anticoagulation and close observation can be effective for patients with SISMAD, particularly those who are stable and have no signs of bowel ischemia. However, it is important to note that each case is unique and treatment should be individualized based on the patient's clinical presentation and imaging findings and surgical intervention may be necessary in some cases if conservative management is unsuccessful or if complications arise.…”