title: Repair of an abdominal aortic aneurysm with a remarkably dilated meandering artery: Report of a case.
abstract: A 73-year-old man on dialysis for chronic renal dysfunction was referred to our hospital for surgical treatment of an abdominal aortic aneurysm (AAA). Preoperative angiography showed a remarkably developed meandering artery branching from the inferior mesenteric artery (IMA). The superior mesenteric and celiac arteries were occluded at the origin, and all blood flow to the abdominal organs was apparently supplied by collateral circulation from the IMA. Considering the risk of mesenteric ischemia after aortic clamping in conjunction during surgery, we used a perfusion catheter with a 12-F balloon to create a shunt to the IMA from the subclavian artery. The operation was successful and the patient recovered uneventfully. We describe this surgical procedure for its effectiveness in preventing postoperative mesenteric ischemia in a rare case of an AAA with complex branching lesions.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Chiba Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inba, Chiba, 270-1694, Japan.
authors.forename: Shun-Ichiro
authors.initials: S
authors.lastname: Sakamoto
authors.forename: Shigeo
authors.initials: S
authors.lastname: Yamauchi
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Yamashita
authors.forename: Hajime
authors.initials: H
authors.lastname: Imura
authors.forename: Yuji
authors.initials: Y
authors.lastname: Maruyama
authors.forename: Masami
authors.initials: M
authors.lastname: Ochi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shimizu
mesh_terms: D000368:Aged; D000792:Angiography; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D002445:Celiac Artery / Q000601:surgery; D003097:Collateral Circulation; D004621:Embolization, Therapeutic / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000517:prevention & control; D008297:Male; D017537:Mesenteric Artery, Inferior / Q000002:abnormalities* / Q000000981:diagnostic imaging; D017538:Mesenteric Artery, Superior / Q000601:surgery; D008643:Mesentery / Q000098:blood supply; D011183:Postoperative Complications / Q000517:prevention & control; D014656:Vascular Surgical Procedures / Q000379:methods*