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Tapered self expandable bare stent to treat acute superior mesenteric artery ischemia
Marta Martinez Miguez1, Coral Carballo-Fernandez, Nilo Mosquera-Arochena
1Departamento de Cirurgia Geral do Complexo Hospitalar de Vigo e Departamentos - Radiologia e de Angiologia e Cirurgia Vascular do Complexo Hospitalar de Ourense, Espanha.
Purpose:
This case demonstrates the use of carotid stents in off-label emergency condition where standard self-expandable stents doesn't fit to native artery and balloon-expandable stents could not be also recommended.
Case Report:
56 years old patient, EVAR therapy performed 2 months before, suffering acute severe abdominal pain; emergency angioCT showed oclusion of superior mesenteric artery (SMA) and no complications related to previous EVAR. A percutaneuos supraselective trombolysis was performed. After 24 hours control DSA showed partial recanalization and tight stenoses in distal SMA with poor run-off to terminal branches. A 6-8 x 40 mm Carotid Stent (Acculink®, Abbot Vascular) was implanted with good inmediate technical result. After 6 months follow up both SMA and branches remain patent and no further treatment was required.
Conclusions:
tapered self expandable uncovered stents are a good treatment option to achieve better conformability to SMA,and bare metal stents do not compromise side-branches of this artery.
