A Case of Chronic Mesenteric Ischemia: Complete Revascularization Using Multiple Procedures

Chronic mesenteric ischemia (CMI) involving occlusion and/or stenosis of multiple mesenteric arteries is rare. We report our experience with a 66-year-old man who presented with a more than 3 months history of abdominal pain and vomiting/diarrhea. A diagnosis of CMI due to occlusion of the superior mesenteric artery (SMA) and severe stenosis of the celiac artery by median arcuate ligament syndrome was made. Complete revascularization through iliac artery–SMA bypass grafting and arcuate ligament dissection assisted with staged-catheter intervention successfully alleviated the patient’s symptoms. The patient has maintained a normal daily diet for 6 months postoperatively.