Mesenteric artery fenestration for type B dissection with visceral ischemia.

We describe a successful case of direct superior mesenteric artery fenestration for an acute type B dissection complicated by bowel necrosis in a 68-year-old man. At 11 days after the onset, computed tomography showed superior mesenteric artery obstruction. We fenestrated and connected the true lumen to the false lumen of the superior mesenteric artery, and performed thrombectomy in both lumens. A bowel resection was carried out immediately. The patient was discharged uneventfully after recovery.