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Using the OUTBACK Catheter to Overcome Aortic Reentry Issues in Retrograde Open Mesenteric Stenting
Iannis Ben Abdallah1, Jean Sénémaud1, Jean-Marc Alsac1
1Department of Vascular and Thoracic Surgery, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France; SURVI (Structure d'URgences Vasculaires Intestinales), Intestinal Stroke Center, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, Université de Paris, Clichy, France; Department of Vascular Surgery, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France.
The OUTBACK catheter helps overcome aortic reentry challenges during retrograde open mesenteric stenting (ROMS) for acute mesenteric ischemia (AMI). This technique improves success rates and reduces bypass needs in complex cases.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Gastroenterology
Background:
- Acute mesenteric ischemia (AMI) presents significant challenges, particularly when flush occlusion of the superior mesenteric artery (SMA) occurs.
- Retrograde open mesenteric stenting (ROMS) is a primary revascularization strategy for thrombotic AMI with intestinal necrosis.
Purpose of the Study:
- To detail the application of the OUTBACK catheter in managing aortic reentry difficulties during ROMS.
- To evaluate the OUTBACK catheter's efficacy in complex ROMS procedures.
Main Methods:
- Demonstration in two patients with late AMI due to SMA flush occlusion.
- Retrograde puncture and recanalization of the SMA via laparotomy.
- Utilizing the OUTBACK catheter and needle for aortic reentry, followed by angioplasty and stenting.
Main Results:
- Successful aortic reentry was achieved using the OUTBACK catheter in challenging ROMS cases.
- The procedure facilitated the completion of ROMS with balloon-expandable covered stents.
Conclusions:
- The OUTBACK catheter is a safe and effective device for addressing aortic reentry issues in ROMS.
- This technique may enhance ROMS success rates and minimize the necessity for emergent bypass surgery in AMI patients.
