Challenging Conventional Treatment: Retrograde Implantation of a Covered Stent in Superior Mensenteric Artery Occlusion Case.

Vascular and endovascular surgery Pub Date : 2025-01-01 Epub Date: 2024-08-23 DOI:10.1177/15385744241278042
Zhang Jie, Zeyi Zhao
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Abstract

Background: This case report describes a novel endovascular technique for treating superior mesenteric artery (SMA) occlusion, a condition leading to chronic mesenteric ischemia (CMI). Traditional treatment methods for CMI, primarily due to SMA stenosis, are often complex and risky, particularly for patients unsuitable for conventional surgery. Objective: This study details the application of retrograde recanalization followed by the deployment of a VIABAHN covered stent in a patient with complete SMA ostium occlusion. Methods: The procedure's success in re-establishing mesenteric blood flow demonstrates its potential as a less invasive, safer alternative to traditional surgical approaches. This technique's innovation lies in its retrograde approach, allowing for effective treatment in cases where antegrade access is unfeasible. Results: The patient showed significant symptom improvement without procedural complications, underscoring the method's efficacy and safety. Conclusion: These findings suggest that retrograde stent implantation can be a viable option for managing SMA occlusions, especially in high-risk surgical cases. The successful application of this technique in this case contributes to the evolving landscape of endovascular interventions in vascular surgery and offers a promising direction for future research and clinical practice in treating SMA-related conditions.

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挑战传统治疗:肠系膜上动脉闭塞病例中的覆膜支架逆行植入术。
背景:本病例报告描述了一种治疗肠系膜上动脉(SMA)闭塞(一种导致慢性肠系膜缺血(CMI)的疾病)的新型血管内技术。肠系膜缺血主要是由 SMA 狭窄引起的,传统的治疗方法往往复杂且风险高,尤其是对于不适合常规手术的患者。研究目的本研究详细介绍了在一名 SMA 管腔完全闭塞的患者身上应用逆行再通路术,然后部署 VIABAHN 覆盖支架的情况。方法:该手术在重建肠系膜血流方面的成功证明了其作为传统手术方法的一种创伤更小、更安全的替代方法的潜力。该技术的创新之处在于其逆行方法,可在无法进行逆行手术的情况下进行有效治疗。结果患者症状明显改善,且无手术并发症,突出了该方法的有效性和安全性。结论这些研究结果表明,逆行支架植入术是治疗 SMA 闭塞的一种可行方法,尤其适用于高风险手术病例。该病例中这一技术的成功应用促进了血管外科血管内介入技术的发展,并为治疗 SMA 相关疾病的未来研究和临床实践提供了一个前景广阔的方向。
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