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Figure 5e. Treatment of AA with percutaneous transluminal angioplasty and stent placement in a heavily calcified SMA. The 73-year-old male patient had lost 25 kg and was experiencing postprandial abdominal pain. (a) Panoramic 3D VR image shows a hypertrophic collateral circulation between the IMA and SMA via the Riolan arcade (arrow). (b-d) Three-dimensional VR (b), sagittal MIP (c), and curved MPR (d) images show stenoses of the celiac trunk and SMA. Heavy calcifications do not allow accurate grading of the stenoses. (e) Pretreatment angiograms helped confirm the high-grade stenosis of the SMA. Placement of a balloon-expandable, 31-gauge stainless-steel stent (6 x 15 mm) in the SMA resulted in complete relief of symptoms. (f-i) A comparison of pretreatment (f, g) and posttreatment (h, i) multi-detector row CT angiograms shows improved vessel patency.
