Abstract
A 72 year old patient with occlusion of the superior mesenteric (SMA) and coeliac arteries (A) had acute mesenteric and foregut ischaemia causing an ischaemic gastroduodenal ulcer, splenic infarction, and pancreatitis. After SMA recanalisation, bowel resection, and failed antegrade coeliac artery recanalisation, retrograde open coeliac stenting was performed through a right subcostal approach with exposure of the liver (#) and duodenum (asterisk) (B). Through the intercostal space, the sheath was introduced into the hepatic artery (white arrow) just upstream of the gastroduodenal artery (black arrow) and advanced into the coeliac aorta, allowing retrograde coeliac recanalisation and stenting.Image 1
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