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Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Mesenteric artery fenestration for type B dissection with visceral ischemia
Yuhei Saitoh1, Hiroshi Ohmori, Yoko Hari
1Department of Cardiovascular Surgery, Matsue Red Cross Hospital, Horo-machi 200, Matsue, Shimane, Japan. sykyy85410@ybb.ne.jp
Asian Cardiovascular & Thoracic Annals
|August 11, 2012
Summary
Direct superior mesenteric artery fenestration successfully treated acute type B dissection with bowel necrosis. This endovascular technique restored blood flow, preventing further complications and leading to patient recovery.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Gastroenterology
Background:
- Acute type B aortic dissection can lead to visceral artery complications, including mesenteric ischemia.
- Superior mesenteric artery (SMA) obstruction poses a significant threat to bowel viability.
Observation:
- A 68-year-old male presented with acute type B dissection complicated by SMA obstruction and subsequent bowel necrosis.
- Computed tomography revealed complete SMA obstruction 11 days post-onset.
Findings:
- Direct SMA fenestration was performed, connecting the true lumen to the false lumen.
- Thrombectomy was successfully executed in both SMA lumens.
- Immediate bowel resection was necessitated by the ischemic damage.
Implications:
- Direct SMA fenestration is a viable endovascular option for managing acute type B dissection with SMA compromise.
- This technique can restore mesenteric perfusion, potentially avoiding more extensive surgical intervention.
- Successful management can lead to favorable patient outcomes, including uneventful recovery.