Percutaneous retrograde revascularization of the occluded celiac artery for chronic mesenteric ischemia using intravascular ultrasound guidance.

A 47-year-old male presented with a triad of postprandial abdominal pain, food fear and significant weight loss since 1 year suggestive of chronic mesenteric ischemia. CT angiogram revealed chronic total occlusion of the celiac artery (CA), inferior mesenteric artery and 80-90 % stenosis of the proximal superior mesenteric artery (SMA). After SMA stenting, successful retrograde recanalisation of chronically occluded CA through pancreatico-duodenal arcade using intravascular ultrasound (IVUS) guidance was done when standard tools failed. The role of IVUS in such challenging lesions is described in the following case report.