Management of symptomatic chronic superior mesenteric artery occlusion by minimally trans-abdominal incision retrograde stent angioplasty

Objective To evaluate the feasibility, safety and validity of minimally trans-abdominal incision retrograde stent angioplasty for the treatment of symptomatic chronic superior mesenteric artery occlusion (SCSMAO). Methods A retrospective analysis was made on 9 SCSMAO patients who received minimally trans-abdominal incision retrograde stent angioplasty. Data of the incision length, puncture position, puncture success rate, whether arterial dissection occurs, implanted stent type and size, blood loss, contrast dose and operation time of the procedure were collected. Results The technical success rate was 100%. Mean incision length was (5.8±0.6)cm and arterial puncture success rate was 100% with no artery dissection and other perioperative major complications. Balloon expandable stents (Boston Scientific, Express LD™) was implanted in all 9 cases successfully, with the size of 7 mm×19 mm in 1 case, 8 mm×37 mm in 7 cases and 9 mm×37 mm in 1 case. Patency rate as confirmed by immediate postoperative angiography was 85%. Shown by follow-up of (17±9)months, all 9 patients reported symptoms disappeared and appetite improved within 1 week after the operation, the mean post 6 months operation weight increase was (4.9±1.2 )kg. One had an asymptomatic in-stent restenosis. There was no stent fracture happened during the follow-up. Conclusions Minimally trans-abdominal incision retrograde stent angioplasty offered new options in the management of SCSMAO. Key words: Mesenteric vascular occlusion; Angioplasty; Stents