Celiac Artery Stenting without Guide Catheter: Bare Wire Stenting

Abstract

Chronic mesenteric ischemia is the most common vascular disorder of the intestines though it is rarely observed in daily clinical practice. Presence of multiple collateral arteries between the superior mesenteric artery and the inferior mesenteric artery is the most likely explanation for the infrequent occurrence of chronic mesenteric ischemia in clinical practice. Atherosclerosis is the most common cause of chronic mesenteric ischemia. The increased utilization of computed tomography and magnetic resonance imaging of abdominal vasculature has increased the diagnosis of the atherosclerotic mesenteric stenosis. Chronic mesenteric ischemia is a clinical diagnosis; it is based upon symptoms and should be supported by anatomic findings. Endovascular therapy has been increasingly utilized for chronic mesenteric ischemia, furthermore early outcomes compare favorably with open mesenteric bypass. Our case study depicts a female patient aged 69 years presenting with post-prandial abdominal discomfort that results in significant weight loss. We here present a case of celiac artery stent restenosis treated by percutaneous transluminal angioplasty and later stenting over bare. 035 inch hydrophylic wire without a guide catheter or sheath because guide catheter was damaged at distal end and stent was not advancable through guide catheter.