Iatrogenic superior mesenteric artery dissection repaired with open septectomy and retrograde balloon control

Complications of mesenteric artery stenting include distal embolization, branch perforation, thrombosis, and dissection. We present the case of a middle-aged woman with acute mesenteric ischemia who was treated with superior mesenteric artery (SMA) stenting resulting in an iatrogenic dissection that was later discovered on computed tomography angiography. SMA dissections pose a particular challenge for endovascular or open therapy, often extending into the distal artery and branches. This case serves a dual purpose: (1) to describe our successful technique with SMA septectomy and retrograde balloon control-an uncommonly performed procedure, and (2) to share lessons learned from our experience with the diagnosis and management of iatrogenic SMA dissection.