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

Abstract

Chronic mesenteric ischemia (CMI) is an uncommon disorder caused by atherosclerotic occlusion or stenosis of the mesenteric arteries (1). CMI symptoms classically develop when there is significant stenosis or occlusion of at least two of the three mesenteric arteries (2). Endovascular therapy is increasingly accepted as the first line of therapy for CMI due to its lower morbidity and mortality rate and similar outcome compared with open surgery (1-5). In celiacomesenteric trunk (CMT), the celiac artery (CA) and superior mesenteric artery (SMA) arise from a common origin (6). Patients with CMT variation develop CMI when atheromatous disease causes occlusion of both the proximal CA and SMA at their common trunk. We report a case of CMT variant with severe stenosis of the trunk ostium and a totally occluded SMA that was successfully treated with overlapping CA and SMA stents in the trunk portion.