Robins J Eli, Young Zane, Glocker Roan J, Stoner Michael C, Doyle Adam J
Department of Surgery, Division of Vascular Surgery, University of Rochester Medical Center, Rochester, NY.
Department of Surgery, Division of Vascular Surgery, University of Rochester Medical Center, Rochester, NY.
Ann Vasc Surg. 2019 Aug;59:306.e11-306.e15. doi: 10.1016/j.avsg.2019.02.039. Epub 2019 May 8.
Ostial stenosis of the superior mesenteric artery (SMA) is usually a benign finding due to the significant collateralization inherent with visceral vessels. There is a subset of patients, however, with significant atherosclerotic disease leading to in situ thrombosis and subsequent mesenteric ischemia requiring intervention. Over the last 20 years, management of mesenteric ischemia-acute or chronic-has transitioned from an open embolectomy or bypass to an endovascular-first approach involving angioplasty and stenting. We are reporting a unique case of recurrent SMA stent fracture with imaging demonstrating diaphragmatic compression of the SMA during the respiratory cycle, subsequent management, and recommendations for future intervention.