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Combined Endovascular and Surgical Retrograde Superior Mesenteric Artery Recanalization 

Combined Endovascular and Surgical Retrograde Superior Mesenteric Artery Recanalization
Chapter:
Combined Endovascular and Surgical Retrograde Superior Mesenteric Artery Recanalization
Author(s):

Syed M. Peeran

DOI:
10.1093/med/9780199986071.003.0027
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date: 29 January 2020

Acute mesenteric ischemia is a life-threatening vascular emergency associated with a very high mortality rate. In the setting of necrotic bowel, the current standard of care requires a laparotomy with bowel resection and surgical or endovascular revascularization of the superior mesenteric artery. Unfortunately, mesenteric bypass confers high perioperative mortality, in some reports up to 45%. A hybrid technique that employs an exploratory laparotomy, catheterization of the distal superior mesenteric artery, and stent deployment across the atherosclerotic lesion was first described in 2004 for the treatment of acute-on-chronic mesenteric ischemia. This chapter describes the appropriate clinical indications, the technical aspects of performing this hybrid procedure, as well as the challenges and common pitfalls encountered.

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