A hybrid repair of a superior mesenteric artery pseudoaneurysm using open mesenteric bypass and endovascular exclusion.

Superior mesenteric artery (SMA) aneurysms and pseudoaneurysms are uncommonly encountered in vascular surgery practice, but they typically require repair. Historically, they have been repaired with open aneurysmorrhaphy, bypass and exclusion, or simple ligation. More recently, endovascular repair with coil embolization and stent graft exclusion have been advocated.

Treatment of an ilioenteric fistula with an Amplatzer Vascular Plug.

Arterioenteric fistulae often present a diagnostic and therapeutic dilemma for physicians. Traditional therapy consists of open repair, which is often poorly tolerated by patients. As a consequence, endovascular repair, consisting primarily of stent graft exclusion, has been attempted by some as a less invasive approach.