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Introduction: The main treatment for Chronic Mesenteric Ischemia (CMI) is revascularization, typically achieved through stent angioplasty of the superior mesenteric artery, and in certain cases, the celiac trunk. However, long-term outcomes using bare-metal stents have been less than satisfactory. Therefore, we aimed to compare the performance of covered stents (CS) versus bare-metal stents (BMS) in patients treated for CMI.

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Jejunal Artery Aneurysm Exclusion With Immediate Vascular Reconstruction: A Case Report.

Port J Card Thorac Vasc Surg

January 2025

Angiology and Vascular Surgery, Unidade Local de Saúde de São João; Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Portugal.

A 44 year-old previously healthy woman presented a persistent epigastric pain. Computed tomography revealed a saccular aneurysm with a diameter of 25x20 mm in the first jejunal artery and also a stenosis in the celiac trunk associated with median arcuate ligament syndrome, turning the hepatic perfusion dependent of the gastroduodenal artery flow. Through a midline laparotomy, celiac axis was exposed, and median arcuate ligament released for median arcuate ligament syndrome treatment.

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Purpose: To report a case series on using a novel semi-branch feature in custom-made stent-grafts in the endovascular treatment of complex aortic aneurysms and summarize the contemporary usage of this technology.

Case Series: Four patients underwent endovascular aortic aneurysm repair (EVAR) with a custom-made semi-branch stent-graft (Semi-Branch Endovascular Aortic Aneurysm Repair [SBEVAR]). Two male patients, 75- and 76-year-old, were treated due to failed EVAR with late-type Ia endoleak, and the other two, 80- and 55-year-old male patients, due to a juxta-renal aortic abdominal aneurysm (JRAAA).

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Objective: As aneurysmal disease is progressive, proximal disease progression and para-anastomotic aneurysms are complications experienced after open infrarenal abdominal aortic aneurysm repair (AAA). As such, fenestrated or branched endovascular repair (F/BEVAR) may be indicated in these patients. Data describing fenestrated endovascular aneurysm repair after prior open repair are limited to institutional databases.

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We present a case of an 86-year-old female with chronic mesenteric ischemia secondary to long-segment flush occlusion of the superior mesenteric artery and near-total occlusion of the celiac artery. The superior mesenteric artery was unable to be revascularized by conventional antegrade approaches. Successful transcollateral crossing of the occluded superior mesenteric artery and body-flossing, followed by antegrade balloon angioplasty, shockwave lithotripsy, and stent implantation were performed.

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