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A 75-year-old man with a past medical history of coronary artery disease, congestive heart failure, and atrial fibrillation presented with chronic postprandial abdominal pain and significant weight loss. His physical exam revealed a soft abdomen with normal bowel sounds and no tenderness to palpation. He underwent computed tomography angiography (CTA) of the abdomen, which demonstrated severe ostial stenoses of the celiac artery, superior mesenteric artery, and inferior mesenteric artery (Figure 37-1). Invasive digital subtraction angiography confirmed the diagnosis of chronic mesenteric ischemia. Given his age and significant comorbidities, the decision was made to proceed with endovascular revascularization as the primary approach. The patient underwent successful placement of 2 balloon-expandable stents in the celiac and superior mesenteric arteries (Figures 37-2 and 37-3). He was discharged home on the same day of the procedure and was asymptomatic on routine outpatient follow-up.
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