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https://www.selleckchem.com/products/larotrectinib.html Chronic mesenteric ischemia is an uncommon disorder in the USA. Frequently, a percutaneous approach is the first therapeutic choice to reduce its symptoms and improve outcomes. After an initial treatment with stents, further interventions might be necessary to address in-stent restenosis and re-establish a better visceral flow. Using laser atherectomy in a similar fashion as used in the peripheral arteries, has proven to be safe helping to achieve a desired final result. We present a case of chronic mesenteric ischemia in a 53-year-old man caused by severe in-stent restenosis who had abdominal pain and weight loss. We used a 0.9 mm laser catheter with low energy and pulse rate as an adjunct to balloon therapy. After revascularization, the patient's symptoms improved dramatically. To the best of our knowledge, this is the first published case in which atherectomy with laser was used to treat severe in-stent restenosis of a mesenteric vessel in chronic mesenteric ischemia. Learning Objective The treatment of severe in-stent restenosis of the superior mesenteric artery using laser atherectomy is safe and can give excellent results when traditional percutaneous therapies fail. © 2020 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.A 58-year-old male with gangrene in his left 1st digit due to critical limb ischemia had undergone endovascular therapy for chronic total occlusion of the left superficial femoral artery using bare-metal stents (BMSs). Angiography revealed in-stent occlusion of the BMS site when he was referred to our hospital with a recurrent ulcer at 7 years after stent implantation. As catheter-directed thrombolysis with urokinase was not effective, surgical thrombectomy was performed. His ankle-brachial index improved, and the ulcer was completely healed after thrombectomy. Pathological evaluation of the retrieved thrombi showed that it consisted of a massive erythrocyte

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