Hybrid recanalization of superior mesenteric artery occlusion in acute mesenteric ischemia.
OBJECTIVE
To describe an alternative hybrid endovascular/open approach to revascularizing the occluded superior mesenteric artery (SMA) in patients with acute ischemia.


METHODS
A laparotomy is performed to assess any visceral ischemia. The SMA is exposed, clamped distally, and cannulated proximally. The SMA occlusion is crossed in a retrograde fashion. Balloon embolectomy or stent implantation may be performed if required. This technique has been used in 6 patients: 2 with acute atherosclerotic occlusion, 1 with thrombotic occlusion and distal emboli, and another 3 in whom the SMA ostium had been covered during placement of a fenestrated stent-graft.


CONCLUSIONS
A hybrid approach to SMA occlusions with retrograde recanalization is feasible. It is of particular use in patients with acute or iatrogenic occlusion and allows assessment of visceral ischemia.
Sonesson
Björn
B
Vascular Centre Malmö-Lund, Malmö University Hospital, Malmö, Sweden.
Hinchliffe
Robert J
RJ
Dias
Nuno V
NV
Resch
Timothy A
TA
Malina
Martin
M
Ivancev
Krassi
K
D000208:Acute Disease; D000792:Angiography; D000800:Angioplasty, Balloon; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D006801:Humans; D017538:Mesenteric Artery, Superior; D008641:Mesenteric Vascular Occlusion / Q000628:therapy*; D011474:Prosthesis Design; D015641:Radiography, Interventional; D015607:Stents; D016896:Treatment Outcome