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Endovascular treatment of chronic mesenteric ischemia is currently the treatment of choice, regardless of the number of involved vessels. Unlike other anatomic areas, the hyperperfusion produced by revascularization and the consecutive reperfusion syndrome is only described in cases of acute bowel ischemia, which is usually resolved with traditional surgery. We present a case of severe hyperperfusion syndrome secondary to endovascular correction with stents of a critical ischemia affecting the celiac trunk and superior mesenteric artery.

A 35-year-old patient was brought to the emergency department referring dysarthria, left ear tinnitus for 5 min, and short-lasting blindness, with headache in the 45 min before the clinical presentation. In the magnetic resonance imaging, an acute-subacute lesion in the cerebellum right-anterior lobe (in the territory of the cerebellum anterior artery) and a dilatation near the ostium of the right vertebral artery were seen. For a better assessment, an Angio-CT was done, showing a 9-mm saccular pseudoaneurysm of the right vertebral artery close to the origin of the vessel, without being able to determine if it had been caused because of a dissection. The rest of the study (cerebral vessels and supra-aortic vessels) showed no disorders. He was operated under local anesthesia and sedation a week after the onset of the symptoms. Through a 0.014 wire, a Biotronik PK Papyrus balloon-expandable covered cobalt-chromium stent was deployed covering the hole in the artery. Antiplatelet drugs were prescribed, and the patient was discharged 24 hr after surgery. He has remained symptom free since then., (Copyright © 2015 Elsevier Inc. All rights reserved.)