Intravascular Ultrasound-Guided Mesenteric Stenting in Patients with Advanced Chronic Kidney Disease

Endovascular treatment of chronic mesenteric ischemia in patients with impaired renal function or allergy to contrast media is a challenging procedure because angiography requires iodinated contrast media for accurate diagnosis and interventional procedures. Superior mesenteric artery stenting without contrast angiography is described in an 81-year-old woman with cardiovascular disease and chronic kidney disease (CKD) stage 5. Balloon angioplasty and stent placement were performed successfully using intravascular ultrasound, pressure wire, surface ultrasound, and fluoroscopy. Intervention without contrast media has wide applicability to patients with advanced CKD and/or those with allergy to iodinated contrast media.