Superior mesenteric artery-to-renal artery bypass: A rare but useful alternative for renal artery revascularization

The aorta, celiac axis, and iliac arteries are the most common inflow arteries used for renal revascularizatior. When these inflow vessels are diseased, the superior mesenteric artery (SMA) can be an alternative source of renal artery graft inflow. Previous reports have suggested that only an enlarged SMA should be used for this purpose, for fear of developing mesenteric ischemia. We report a patient who required renal artery revascularization with a saphenous vein graft from a normal-caliber SMA who did not develop subsequent mesenteric ischemia. The procedure was unique in demonstrating that the SMA can be used as a viable source of graft inflow even when it is anatomically normal.