Antegrade revascularization of the three mesenteric vessels to treat chronic mesenteric ischemia

Chronic mesenteric ischemia is a serious vascular disease that progresses with acute mesenteric ischemia, along with high mortality. Elective intervention has been shown to prevent this progression and improve symptoms. Controversy remains about whether antegrade or retrograde mesenteric bypass has better outcomes and whether restoration of flow to a single vessel versus multiple mesenteric vessels should be performed. This study reports on our experience using an antegrade prosthetic bypass graft to treat chronic occlusions of the celiac trunk, superior mesenteric artery, and inferior mesenteric artery at their origins, all of which result in visceral ischemia.

Recurrent Mesenteric Ischemia from Celiomesenteric Trunk Stenosis

A common origin of the celiac trunk and superior mesenteric artery (SMA), also termed as celiomesenteric trunk (CMT), is a rare occurrence. We report a rare case of symptomatic CMT stenosis requiring multiple interventions. The patient underwent an initial superior mesenteric artery bypass graft but required a subsequent endoluminal intervention. We present this case for the rarity of CMT stenosis and its potential to cause recurrent mesenteric ischemia. The treatment outcome in this patient suggests that revascularization of the SMA alone can result in adequate perfusion of the entire mesenteric bed and resolve symptoms of mesenteric ischemia including weight loss and food avoidance.