ABSTRACT
Mesenteric ischemia can be classified as either acute or chronic. Acute mesenteric ischemia presents with symptom onset over hours to days and demands prompt diagnosis and revascularization, as well as open or laparoscopic abdominal exploration to assess gut viability and to resect nonviable intestinal segments. The role of endovascular management of acute mesenteric ischemia remains limited to hybrid retrograde stenting of an underlying superior mesenteric artery (SMA) stenosis. Complications associated with any endovascular procedure include access site hematoma or vessel thrombosis. The hybrid approach is valuable in patients presenting with acute or acute-on-chronic nonembolic mesenteric ischemia undergoing laparotomy for evaluation of bowel viability. The advantages of this technique include its minimal access requirement (inframesocolic exposure) and the use of mesenteric thrombectomy and arteriotomy for retrograde sheath access. This technique can restore flow to the gut faster and less invasively than a mesenteric bypass in a critically ill patient.
