# Fenestrated endovascular aortic repair of a superior mesenteric artery aneurysm using carbon dioxide angiography and intravascular ultrasound

## TL;DR

This paper presents a new method for repairing a rare type of artery aneurysm using safer imaging techniques to avoid contrast-related complications.

## Contribution

The paper introduces a novel approach using carbon dioxide angiography and intravascular ultrasound for fenestrated endovascular repair.

## Key findings

- Carbon dioxide angiography and intravascular ultrasound can safely guide endovascular repair in patients with severe contrast allergies.
- This method avoids the risks of iodinated contrast, such as allergic reactions and nephropathy.
- The approach was successfully applied to a rare superior mesenteric artery aneurysm.

## Abstract

Superior mesenteric artery aneurysms are rare; however, current guidelines suggest they all require repair due to the high rupture and mortality rates, and endovascular repair is an effective management strategy. Iodinated contrast traditionally used in endovascular repair can cause significant complications, including severe allergic reactions and contrast-induced nephropathy in patients with chronic renal disease. Therefore, other imaging methods should be used during endovascular procedures to reduce these risks. We describe a unique and innovative approach using carbon dioxide angiography and intravascular ultrasound during fenestrated endovascular repair of an uncommon superior mesenteric artery aneurysm in a patient with severe contrast allergies.