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Endovascular treatment for distal aortic occlusive disease with concomitant asymptomatic chronic mesenteric ischemia: Successful revascularization of the aorta and inferior mesenteric artery using the kissing-stents technique
Marisa Toma, MD, Angelo Santos, MD, Bart Chess, MD, Satish Muluk, MD.
Allegheny General Hospital, Pittsburgh, PA, USA.

Objective: Focal infrarenal aortic stenosis is relatively rare. Traditionally, aortic endarterectomy and aortic bypass surgery have been used to treat these lesions. However, percutaneous transluminal angioplasty (PTA) and stenting have become well-defined alternatives to surgery.
Methods: We present 62-year-old female with bilateral ischemic rest pain. Angiography revealed severe stenosis of the mid-infrarenal aorta adjacent to an enlarged, patent inferior mesenteric artery (IMA) along with stenoses of the celiac artery (CA) and proximal superior mesenteric artery (SMA). Endovascular stents were utilized to improve flow to the distal aorta maintain patency of the IMA.
Results: The kissing-stents technique was used successfully to treat the aortic lesion and protect the IMA orifice. see figures
Conclusion: Kissing Aortic and IMA stents is a viable option for ensuring IMA patency when treating distal aortic lesions by endovascular means in patients with asymptomatic multi-vessel mesenteric artery disease.


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