Revascularization of superior mesenteric artery occlusion via the arc of Buhler: A case report and literature review

BackgroundTo report revascularization of a superior mesenteric artery (SMA) ostial occlusion via the Arc of Buhler.Case ReportA 62-year-old female presented with 2 months of recurrent abdominal distension and postprandial pain. Computed tomography angiography (CTA) revealed ostial occlusion of the SMA with distal perfusion via the Arc of Buhler (connecting the celiac trunk and SMA). Conventional endovascular techniques failed. A 0.014 guidewire was passed retrograde through the occlusion via the Arc of Buhler. The guidewire was captured from the femoral sheath and balloon angioplasty with stent placement was performed. The patient had complete symptom resolution post-procedure.ConclusionsRetrograde revascularization via the Arc of Buhler is an effective method for treating the initial segment occlusion of the SMA.