# Visceral Artery Revascularization With the "Roof-Top" Approach: An Alternative Technique With Great Exposure of the Suprarenal Aorta

## TL;DR

This paper presents a case where a patient with intestinal angina was treated using an alternative open surgical technique called the 'roof-top' approach for visceral artery revascularization.

## Contribution

The paper introduces the 'roof-top' approach as an alternative surgical technique for visceral artery revascularization.

## Key findings

- The 'roof-top' approach provides excellent exposure of the suprarenal aorta.
- The approach was successfully used in a patient unsuitable for endovascular repair.
- The technique is a totally abdominal approach and avoids traditional midline incisions.

## Abstract

Due to the extensive collateral arterial network, symptomatic chronic mesenteric ischemia is a relatively uncommon condition and is associated with severe atherosclerotic disease of all major visceral arteries. Open surgical repair has been commonly used to restore blood supply to the visceral arteries, and the "roof-top" approach has been advocated as an alternative technique to traditional midline incision, mainly because of the great exposure of the suprarenal aorta that it offers. Roof-top approach, in other words, bilateral subcostal incision, is a totally abdominal approach to the suprarenal aorta, and as the title says, it is like a roof-top on the abdominal wall. We present a case of a female patient with intestinal angina that was deemed unsuitable for endovascular repair (ER) and was treated with open surgical repair utilizing the "roof-top" approach.