Successful Use of Orbital Atherectomy as an Adjunct in Treating Extensively Calcified Mesenteric Artery Lesions

Ann Vasc Surg. 2016 Oct:36:296.e5-296.e8. doi: 10.1016/j.avsg.2016.04.009. Epub 2016 Jul 15.

Abstract

Background: To describe the use of orbital technique of atherectomy as an adjunct to successful angioplasty and stent placement of the superior mesenteric artery (SMA).

Case report: The technique is demonstrated in a 68-year-old man with critical SMA stenosis. The SMA was cannulated with 0.014-in wire, but the lesion was highly stenotic and densely calcified and prevented the passage of even the smallest 1.5-mm balloon. Orbital atherectomy was thus performed with a 1.25-mm CSI crown. Balloon angioplasty was then possible with a 4 mm × 2 cm balloon followed by placement of a 7 mm × 22 mm balloon-mounted stent.

Conclusions: The use of atherectomy as an adjunct to angioplasty and stenting in extensive, calcified SMA lesions supports the value of this technique to avoid a much larger and morbid open procedure.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angioplasty, Balloon* / instrumentation
  • Atherectomy / methods*
  • Computed Tomography Angiography
  • Humans
  • Male
  • Mesenteric Artery, Superior / diagnostic imaging
  • Mesenteric Artery, Superior / physiopathology
  • Mesenteric Vascular Occlusion / diagnostic imaging
  • Mesenteric Vascular Occlusion / physiopathology
  • Mesenteric Vascular Occlusion / therapy*
  • Severity of Illness Index
  • Splanchnic Circulation
  • Stents
  • Treatment Outcome
  • Vascular Calcification / diagnostic imaging
  • Vascular Calcification / physiopathology
  • Vascular Calcification / therapy*