Back to 2025 Abstracts
Iatrogenic Superior Mesenteric Artery Aneurysm After Shockwave Therapy For Occlusive Mesenteric Disease
Dorcie Ann Gillette, MD, Adeola Odugbesi, MD.
University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
DEMOGRAPHICS: Superior mesenteric aneurysms are quite rare and account for 6-15% of all visceral aneurysms. Most are degenerative in nature, but we present a case of an iatrogenic SMA aneurysm after shockwave therapy for chronic mesenteric disease.
HISTORY: 71-year-old male with severe PAD and a history of an AKA and previous SMA stenting performed at an outside hospital. During the original SMA intervention 6 months prior, the patient underwent shockwave lithotripsy of the calcified vessel followed by placement of a 7MM Visipro bare metal stent followed by further shockwave lithotripsy of the stent due to severe residual disease. Subsequent CTA one month later showed complete fracture of the stent in the midportion and an iatrogenic 3 cm SMA aneurysm (Figure 1). Proper workup was performed to confirm there was no mycotic nature to the aneurysm.
PLAN: The patient was taken to the operating room and via a transfemoral access, the proximal fractured stent of the SMA was selected (Figure 2). During attempts to achieve wire access through the distal end, the fractured stent dislodged into the aneurysm sac. Eventually, the distal SMA was selected, and the entire area relined with a 7MMx59MM VBX stent graft. Repeat angiogram showed no endoleak and a widely patent vessel. CTA one month later demonstrated complete exclusion of the aneurysm with maintained patency of the SMA stent (Figure 3).
DISCUSSION: Although shockwave lithotripsy plays a significant role in the management of peripheral occlusive disease, caution must be practiced when it comes to utilizing this therapy in patients with occlusive mesenteric disease.
Back to 2025 Abstracts
